The impression of direct vertebral rotation (DVR) on radiographic end result in surgical correction of idiopathic scoliosis.
Arch Orthop Trauma Surg. 2017 Jul;137(7):879-885
Authors: Urbanski W, Wolanczyk MJ, Jurasz W, Kulej M, Morasiewicz P, Dragan SL, Sasiadek M, Dragan SF
INTRODUCTION: Latest developments of spinal devices permit to handle practically all elements of idiopathic scoliosis. Direct vertebral rotation (DVR) maneuver was launched to appropriate apical axial vertebral rotation. It’s nonetheless nonetheless not properly established how effectively DVR impacts outcomes of scoliosis correction. The thing of the examine was to judge en bloc apical vertebral rotation (DVR) and its impression on coronal and sagittal correction of the backbone in sufferers present process surgical scoliosis remedy.
MATERIALS AND METHODS: Thirty-six consecutive sufferers who underwent posterior spinal fusion with pedicle screws solely constructs for idiopathic scoliosis. Fifteen sufferers (20 curves) have been corrected by rod derotation solely and 21 sufferers (26 curves) had each rod derotation and DVR. Curve measurements have been carried out on x-rays obtained earlier than and postoperatively-coronal curves, kyphosis (T2-T12, T5-T12). Backbone flexibility was assessed on susceptible bending x-rays. Apical axial rotation was decided on CT scans obtained intraoperatively and postoperatively. Rotation angle (RAsag) was measured in line with Aaro and Dahlborn.
RESULTS: We noticed discount of RAsag in all sufferers; nonetheless, in DVR group, lower was better, by 31.eight% evaluating to non-DVR group, by eight.6% (p = zero.0003). Imply coronal correction in DVR group was 68.eight% and in rod derotation group with out DVR 55% (p = zero.002). No vital correlation was discovered between diploma of derotation obtained and coronal correction. In DVR group T2-T12 kyphosis has elevated in 28 (65%) sufferers whereas in non-DVR group in 31 (69%) circumstances. Imply worth of T2-T12 kyphosis development was 16.7% in DVR and 22.1% in non-DVR group. These variations nonetheless didn’t happen statistically vital.
CONCLUSIONS: Direct vertebral rotation (DVR) maneuver reduces considerably apical rotation of the backbone, enhances potential of coronal correction, and it doesn’t scale back thoracic kyphosis.
PMID: 28439703 [PubMed – indexed for MEDLINE]