Correction of Double Thoracic Adolescent Idiopathic Scoliosis Using PedicleScrew Instrumentation: Comparison with Translation and Rod Derotation / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To compare the results of two different surgical methods (translation vs rod derotation) in a correction of double thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation. MATERIALS AND METHODS: Forty-seven patients with double thoracic AIS treated by pedicle screw instrumentation were reviewed retrospectively after a minimum follow-up of 2 years. The patients were divided into two groups; TR group (translation method, n=14) and RD group (rod derotation, n=33). There were no significant differences in the preoperative curve characteristics between the two groups. RESULTS: In the TR group, the preoperative upper thoracic curve of 37+/-4 degrees improved to 24+/-4 degrees (35% correction), and the lower thoracic curve of 52+/-9 degrees improved to 18+/-5 degrees (65% correction). In the RD group, the preoperative upper thoracic curve of 40+/-7 degrees improved to 19+/-7 degrees (51% correction), and the lower thoracic curve of 56+/-12 degrees was improved to 16+/-6 degrees (72% correction). The correction of the upper and lower thoracic curves was significantly better in the RD group (p<0.05). Thoracic sagittal kyphosis was corrected from 21 degrees to 24 degrees in the TR group and from 18 degrees to 26 degrees in the RD group. There was no significant difference in the spinal balance, shoulder height difference, T1 tilt and fusion extent. The operating time and the amount of blood loss was 231 minutes and 2050ml in the TR group and 263 minutes and 3217ml in the RD group, respectively (p<0.05). CONCLUSION: In correcting double thoracic AIS using pedicle screw instrumentation, the rod derotation method showed better correction for the upper and lower thoracic curves. The translation method showed the advantages of easier application, a shorter operation time and less blood loss.