Journal List > J Korean Orthop Assoc > v.26(3) > 1115068

Suk, Lee, Cho, and Chung: Zielke VDS in the Treatment of Scoliosis

Abstract

Zielke ventral derotation spondylodesis (VDS) has been the anterior instrumentation of choice for scoliosis correction. Thirty-two patients of scoliosis treated by Zielke VDS were reviewed to assess their results in curve correction, to evaluate its use combined with posterior instrumentation and to find its effect on the whole spine. There were 20 idiopathic, 5 neuropathic, 3 congenital, 4 other scoliotics with average age of 17.3 years (range, 11.4 to 29.8 years). Mean follow up was 38.2 months (range, 15 to 60 months). Posterior procedures of Harrington, Luque or Cotrel-Dubousset were combined in 3 neuropathic, 1 neurofibromatosis, 1 congenital, 1 idiopathic, and 1 arthrogryposis patients. The average frontal Cobb angle correction was 74% and loss of correction at final follow up was 2.6°. Instrumentation kyphosis of average 6°resulted. Apical vertebra rotation as determined by Pedriolle method was corrected by 42%. The upper compensatory curves were rather reluctant to spontaneous correction than the lower one, and in two cases, secondary thoracic curve correction was necessary due to curve decompensation from overcorrection. Zielke VDS provides powerful frontal and rotational correction, though it is difficult to maintain or restore physiologic sagittal curves. The spontaneous correction of upper compensatory curve is determined by its flexibility rather than the major curve correction, and overcorrection of the major curve would result in curve decompensation. And Zielke VDS can be effective as combined with posterior instrumentation in particular cases.

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