Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis
Study DesignRetrospective study.PurposeTo determine the effect and direction of direct vertebral rotation (DVR) in the lowest instrumented vertebra (LIV) on the uninstrumented lumbar curve depending on the lumbar modifier used for the correction of thoracic adolescent idiopathic scoliosis.Overview o...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2017-02-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-11-127.pdf |
| _version_ | 1811319455600345088 |
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| author | Sung-Soo Kim Jung-Hoon Kim Se-Il Suk |
| author_facet | Sung-Soo Kim Jung-Hoon Kim Se-Il Suk |
| author_sort | Sung-Soo Kim |
| collection | DOAJ |
| description | Study DesignRetrospective study.PurposeTo determine the effect and direction of direct vertebral rotation (DVR) in the lowest instrumented vertebra (LIV) on the uninstrumented lumbar curve depending on the lumbar modifier used for the correction of thoracic adolescent idiopathic scoliosis.Overview of LiteratureDVR in the LIV should be implemented in a different direction to obtain better spontaneous lumbar correction depending on the preoperative lumbar spine modifier.MethodsWe retrospectively analyzed 160 patients with thoracic adolescent idiopathic scoliosis treated by pedicle screw instrumentation and rod derotation. Patients who had a distal fusion level between T11 and L1 were divided into two groups: the DVR group versus the No-DVR group. Each group was divided into subgroups depending on the lumbar modifier used: the DVR-A, B, and C groups versus the No-DVR-A, B, and C groups. The DVR-A group was subdivided into two subgroups depending on the direction of screw rotation in the LIV: the DVR-A-O group (opposite direction) and the DVR-A-S group (same direction).ResultsThere were no significant differences in the preoperative curve characteristics between the two groups. The preoperative lumbar curve was corrected in 70% of the patients in the DVR group and in 56% in the No-DVR group. Spontaneous coronal correction of the lumbar curve was better in the DVR-A-S group than that in the No-DVR-A group. However, the DVR-A-O group had the higher incidence of adding-on deformity. The DVR-B and C groups showed better spontaneous correction of lumbar coronal magnitude, apical vertebral translation, and rotation and the LIV tilting.ConclusionsIn lumbar modifiers B and C, screws in the LIV have to be rotated opposite to the direction of the screw rotation of the main thoracic curve; however, in modifier A, the screws have to be rotated in the same direction. |
| first_indexed | 2024-04-13T12:43:30Z |
| format | Article |
| id | doaj.art-2df94f53057241f4a60d1f01d0cb612e |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-13T12:43:30Z |
| publishDate | 2017-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-2df94f53057241f4a60d1f01d0cb612e2022-12-22T02:46:27ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462017-02-0111112713710.4184/asj.2017.11.1.127192Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic ScoliosisSung-Soo Kim0Jung-Hoon Kim1Se-Il Suk2Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea.Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.Study DesignRetrospective study.PurposeTo determine the effect and direction of direct vertebral rotation (DVR) in the lowest instrumented vertebra (LIV) on the uninstrumented lumbar curve depending on the lumbar modifier used for the correction of thoracic adolescent idiopathic scoliosis.Overview of LiteratureDVR in the LIV should be implemented in a different direction to obtain better spontaneous lumbar correction depending on the preoperative lumbar spine modifier.MethodsWe retrospectively analyzed 160 patients with thoracic adolescent idiopathic scoliosis treated by pedicle screw instrumentation and rod derotation. Patients who had a distal fusion level between T11 and L1 were divided into two groups: the DVR group versus the No-DVR group. Each group was divided into subgroups depending on the lumbar modifier used: the DVR-A, B, and C groups versus the No-DVR-A, B, and C groups. The DVR-A group was subdivided into two subgroups depending on the direction of screw rotation in the LIV: the DVR-A-O group (opposite direction) and the DVR-A-S group (same direction).ResultsThere were no significant differences in the preoperative curve characteristics between the two groups. The preoperative lumbar curve was corrected in 70% of the patients in the DVR group and in 56% in the No-DVR group. Spontaneous coronal correction of the lumbar curve was better in the DVR-A-S group than that in the No-DVR-A group. However, the DVR-A-O group had the higher incidence of adding-on deformity. The DVR-B and C groups showed better spontaneous correction of lumbar coronal magnitude, apical vertebral translation, and rotation and the LIV tilting.ConclusionsIn lumbar modifiers B and C, screws in the LIV have to be rotated opposite to the direction of the screw rotation of the main thoracic curve; however, in modifier A, the screws have to be rotated in the same direction.http://www.asianspinejournal.org/upload/pdf/asj-11-127.pdfSpineScoliosisAdolescentRotationPedicle screws |
| spellingShingle | Sung-Soo Kim Jung-Hoon Kim Se-Il Suk Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis Asian Spine Journal Spine Scoliosis Adolescent Rotation Pedicle screws |
| title | Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis |
| title_full | Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis |
| title_fullStr | Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis |
| title_full_unstemmed | Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis |
| title_short | Effect of Direct Vertebral Rotation on the Uninstrumented Lumbar Curve in Thoracic Adolescent Idiopathic Scoliosis |
| title_sort | effect of direct vertebral rotation on the uninstrumented lumbar curve in thoracic adolescent idiopathic scoliosis |
| topic | Spine Scoliosis Adolescent Rotation Pedicle screws |
| url | http://www.asianspinejournal.org/upload/pdf/asj-11-127.pdf |
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