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Vertebral coplanar alignment technique: a surgical option for correction of adult thoracic idiopathic scoliosis

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Abstract

Purpose

Previous studies have demonstrated vertebral coplanar alignment (VCA) as an effective surgical option for adolescent idiopathic scoliosis (AIS). The purpose of this study is to analyze the outcome of VCA for the surgical correction of adult idiopathic scoliosis (AdIS).

Methods

35 AdIS patients (mean age: 24.2 years) undergoing VCA-instrumentation were reviewed. The main thoracic curve and thoracic kyphosis (TK, T5-T12) were evaluated preoperatively, immediate postoperatively, and at the final follow-up (>1 year). All patients were stratified by the TK modifier before surgery: “+” (TK, >40°), “−” (TK, <10°), and “N” (TK, 10°–40°) for normal. The apical vertebral body-to-rib ratio (AVB-R), rib hump (RH), and rotational angle to sacrum (RAsac) were measured to assess the correction of rotational deformity. Quality of life was evaluated with SRS-20 questionnaires.

Results

The main thoracic curve (59.1° vs. 19.3°, P < 0.001) and rotational deformity (AVB-R: 2.4 vs. 1.7 %, P < 0.001, RH: 34.9 vs. 19.1 mm, P < 0.001, RAsac: 19.6° vs. 11.9°, P < 0.001) were significantly reduced with surgery. Sagittal deformity improved significantly in group “+” (51.4° vs. 31.6°, P < 0.001) and group “−” (6.2° vs. 20.1°, P < 0.001), while no significant postoperative change in TK was observed in group “N” (23.5° vs. 26.3°, P = 0.270). Patients were followed for an average of 18.7 months with no significant loss of correction. SRS scores improved greatly from 57.7 preoperatively to 71.6 at the final follow-up.

Conclusions

VCA can be effectively used for the correction of the coronal and rotational deformity, with better sagittal profile restoration in adult thoracic idiopathic scoliosis with sagittal malalignment.

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Acknowledgments

National Public Health Benefit Research foundation, China (Grant No. 201002018), funds were received in support of this work.

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Authors and Affiliations

  1. Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China

    Shouyu He, Hongda Bao, Zezhang Zhu, Yong Qiu, Feng Zhu, Hengcai Zhou, Xu Sun & Bin Wang

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  1. Shouyu He
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  2. Hongda Bao
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  3. Zezhang Zhu
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Correspondence to Feng Zhu.

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We declare that we have no actual or potential conflict of interest in relation to this article. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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He, S., Bao, H., Zhu, Z. et al. Vertebral coplanar alignment technique: a surgical option for correction of adult thoracic idiopathic scoliosis. Eur Spine J 25, 417–423 (2016). https://doi.org/10.1007/s00586-015-4080-1

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