Correction of Double Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation - Comparison with Translation and Rod Derotation

Jin-Hyok Kim; Sung-Soo Kim; Nak-Yong Jung; Jung-Hun Kim; Jung-Il Han; Ho-Jong Ra; Sang-Jin Lee; Se-Il Suk

doi:10.4055/jkoa.2007.42.5.671

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Kim, Kim, Jung, Kim, Han, Ra, Lee, and Suk: Correction of Double Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation - Comparison with Translation and Rod Derotation

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(5): 671-678.

Published online: 31 October 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.5.671

Correction of Double Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation - Comparison with Translation and Rod Derotation

Jin-Hyok Kim, M.D., Sung-Soo Kim, M.D., Nak-Yong Jung, M.D., Jung-Hun Kim, M.D.^*, Jung-Il Han, M.D., Ho-Jong Ra, M.D., Sang-Jin Lee, M.D., Se-Il Suk, M.D.

Seoul Spine Institute, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, College of Medicine, Inje University, Ilsan Paik Hospital, Goyang, Korea.

Address reprint requests to Sung-Soo Kim, M.D. Seoul Spine Institute, College of Medicine, Inje University, Sanggye Paik Hospital, 761-1, Sanggye-dong, Nowon-gu, Seoul 139-707, Korea. Tel: +82.2-950-1288, Fax: +82.2-934-6342, toetotoe1@sanggyepaik.ac.kr

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° improved to 24±4° (35% correction), and the lower thoracic curve of 52±9° improved to 18±5° (65% correction). In the RD group, the preoperative upper thoracic curve of 40±7° improved to 19±7° (51% correction), and the lower thoracic curve of 56±12° was improved to 16±6° (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° to 24° in the TR group and from 18° to 26° 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.

Keywords: Idiopathic scoliosis, Double thoracic curve, Pedicle screw instrumentation, Translation, Rod derotation

Figures and Tables

Table 1

Coronal Deformity and Apical Vertebral Translation

^*AVT, Apical vertebral translation; ^†Immediate PO, Immediate postoperative; ^‡Curve Corr, Correction rate of curve; ^§p-value was <0.05 when comparing the values between the two groups

Table 2

Other Parameters

^*p-value was calculated from the comparison of the values at the final follow-up between two groups. ^†SHD, Shoulder height difference, ^‡LIVT, Lowest instrumented vertebral tilting.

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