Evaluation of Vertebral derotation in the correction of Adolescent Idiopathic Scoliosis

Abstract

Abstract Background Adolescent idiopathic scoliosis (AIS) represents a complex three-dimensional deformity. The rotation of the apical vertebrae is primarily responsible for the rib hump that represents the main cosmetic problem for adolescent patients. Correcting rotational deformity and maintaining the normal sagittal profile of the spine is more important than onlycorrecting coronal deformity. Aim of the Work to evaluate the efficacy of vertebral derotation using Single Concave Rod Rotation (SCRR) maneuver in the treatment of patients with Adolescent Idiopathic Scoliosis (AIS) by clinical and radiological follow up for 1 year. Patients and Methods This prospective analysis was done on 30 patients with AIS, who underwent one stage posterior only corrective surgery with SCRR maneuver between 2016 and 2019 at Ain Shams University Hospitals in order to correct their deformities. All patients included in this study had idiopathic curve between 40 and 80 degrees, with flexibility index < 50%, and their ages were between 10 and skeletal maturity. Results Compared to the results obtained by other studies using the same technique, our study included patients with relatively large curve magnitude and the lowest flexibility index, had average coronal correction rate by about 65.5% and minimal correction loss during follow up (-1°). Furthermore, our study included the largest mean preoperative RA. The axial correction rate was average (32.7%) and has the lowest complication rate and better clinical outcome and patient satisfaction among other studies that used SCRR maneuver. However, the mean operating time in our series in the present study was longer than the mean operating time in the literature. The mean amount of blood loss in our study was more than the mean amount in other studies. Conclusion Simple concave rod rotation is a good option for correction of the deformed curve in AIS. We can state that simple concave rod rotation with pedicle screw instrumentation and without the use of DVD maneuver could successfully correct both coronal and axial deformity with minimal complication. Adding DVD technique offers a better correction of apical vertebra rotation.