Direct Vertebral Rotation (DVR): A New Technique of 3-D Deformity Correction with Segmental Pedicle Screw Fixation in Adolescent Idiopathic Scoliosis (AIS).
10.4184/jkss.2003.10.2.180
- Author:
Sang Min LEE
1
;
Se Il SUK
;
Ewy Ryong CHUNG
Author Information
1. Seoul Spine Institute, Inje University Sanggye Paik Hospital. snoopy5@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Idiopathic scoliosis;
Pedicle screw fixation;
Rotational correction;
Direct vertebral rotation (DVR)
- MeSH:
Adolescent*;
Congenital Abnormalities*;
Humans;
Prospective Studies;
Scoliosis*
- From:Journal of Korean Society of Spine Surgery
2003;10(2):180-190
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A prospective study. OBJECTIVES: To introduce a new technique, direct vertebral rotation (DVR), and to compare the surgical results with those of a simple rod derotation (SRD). SUMMARY OF BACKGROUND DATA: Pedicle screw fixation, with a simple rod derotation maneuver, enables powerful coronal and sagittal plane corrections in scoliosis surgery. However, the ability for rotational correction is still unclear. METHODS: Thirty-eight AIS patients, treated with segmental pedicle screw fixation, were analyzed. The first group (n=17) was treated by DVR, and the second (n=21) by SRD. Having similar preoperative curve patterns, both groups were evaluated for the deformity correction and spinal balance. RESULTS: In the DVR group, the average preoperative AVR of 16.7 degrees was corrected to 9.6 degrees, showing a 42.5% correction, while in the SRD group, the correction was negligible, from 16.1 degrees to 15.7 degrees(2.4%). In the DVR group, the preoperative thoracic curve of 55 degreeswas corrected to 12 degrees(79.6%), and the lumbar curve from 39 degreesto 7 degrees(80.5%). In the SRD group, the preoperative thoracic curve of 53 degreeswas corrected to 17 degrees(68.9%), and the lumbar curve from 39 degreesto 16 degrees(62.2%). The average LIVT correction was 80.6 and 66.3% in the DVR and SRD group, respectively. There were statistically significant differences in the coronal curve, LIVT and rotational correction (p<0.05, Mann-Whitney u test). CONCLUSIONS: The segmental pedicle screw fixation with 'direct vertebral rotation'showed better rotational and coronal corrections than the 'simple rod derotation'.
