Surgical Outcomes of a New Technique Using a Convex Rod Rotation Maneuver for Adolescent Idiopathic Scoliosis.

Adolescent idiopathic scoliosis Apical vertebral rotation Convex rod rotation maneuver Correction rate

Journal

Spine surgery and related research
ISSN: 2432-261X
Titre abrégé: Spine Surg Relat Res
Pays: Japan
ID NLM: 101718059

Informations de publication

Date de publication:
2021
Historique:
received: 01 10 2020
accepted: 31 10 2020
entrez: 28 6 2021
pubmed: 29 6 2021
medline: 29 6 2021
Statut: epublish

Résumé

Because of adolescent idiopathic scoliosis (AIS), most surgeons use rod rotation on the concave side for Lenke types 1 and 2 curves. Nevertheless, the accurate placement of pedicle screws within dysplastic pedicles, especially on the concave side, is sometimes challenging. Conversely, there is a concern that apical rotation might be exacerbated after convex rod rotation maneuver (RRM) because the rod is rotated in the same direction as vertebral rotation. This study aims to demonstrate the surgical technique and outcomes of a convex RRM with direct vertebral rotation (DVR) for the correction of AIS. Multilevel pedicle screws were inserted into the vertebrae. The pre-bent pure titanium rod was set on the convex side and then derotated to nearly 90°. DVR was conducted for the desired vertebrae. Another pre-bent titanium alloy rod, for placement on the concave side, was contoured the same as the rod on the convex side. Using a reduction tube that allowed easier capture of the rod, the rod was connected to the concave side screws. DVR was again conducted for the desired vertebrae. Among the 59 patients, the correction rate of the main thoracic curve in Lenke types 1 and 2 AIS was 75.1% and 65.0%, respectively. The absolute value of the change in apical vertebral rotation between pre- and post-operative computed tomography (CT) scans in Lenke types 1 and 2 curves was 4.8° and 4.2°, respectively. The convex RRM improved vertebral rotation in Lenke types 1 and 2 AIS. This procedure should be regarded as one of the surgical options for AIS, especially in patients with a narrow pedicle width on the concave side.

Identifiants

pubmed: 34179559
doi: 10.22603/ssrr.2020-0185
pmc: PMC8208944
doi:

Types de publication

Journal Article

Langues

eng

Pagination

205-210

Informations de copyright

Copyright © 2021 by The Japanese Society for Spine Surgery and Related Research.

Déclaration de conflit d'intérêts

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

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Auteurs

Shinji Takahashi (S)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Hidetomi Terai (H)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Hiromitsu Toyoda (H)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Masatoshi Hoshino (M)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Akinobu Suzuki (A)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Koji Tamai (K)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Shoichiro Ohyama (S)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Yusuke Hori (Y)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Akito Yabu (A)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Hiroaki Nakamura (H)

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Classifications MeSH