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. 2018 Jul-Aug;52(4):363-368.
doi: 10.4103/ortho.IJOrtho_447_16.

Is Convex Derotation Equally Effective as Concave Derotation for Achieving Adequate Correction of Selective Lenke's Type- 1 Scoliosis?

Arun-Kumar Kaliya-Perumal  1   2 , Yu-Cheng Yeh  1 , Chi-Chien Niu  1 , Lih-Huei Chen  1 , Wen-Jer Chen  1 , Po-Liang Lai  1
Affiliations

Is Convex Derotation Equally Effective as Concave Derotation for Achieving Adequate Correction of Selective Lenke's Type- 1 Scoliosis?

Arun-Kumar Kaliya-Perumal et al. Indian J Orthop. 2018 Jul-Aug.

Abstract

Background: Correcting the scoliosis and stabilizing the spine in the corrected position is the basis of treatment for adolescent idiopathic scoliosis (AIS). Spinal instrumentation and derotation are the principle steps of surgery for any type of AIS. A perspicuous understanding needs to be attained regarding derotation maneuvers in practice; therefore, we intend to compare radiological outcomes following concave and convex rod derotation maneuvers to analyze their efficacy to correct selective Lenke's Type-1 scoliosis.

Materials and methods: Retrospectively, 88 patients with Lenke's Type-1 scoliosis who were operated with selective thoracic instrumentation were divided into two groups depending on the derotation side. Preoperative radiographs were analyzed for curve angles, thoracic apical vertebral translation, apical vertebral rotation, and coronal/sagittal balance. Postoperative and followup assessment was focused on curve correction. Correction rate of main thoracic (MT) curve and its corresponding loss of correction at final followup are calculated.

Results: Concave group (n = 40; age 13.8 ± 1.9) and the convex group (n = 48; Age 14.3 ± 2.4) showed similar demographic characteristics. Postoperative and followup parameters showed no significant difference. Correction rate of MT curve between both groups (concave group = 69.2 ± 10.5%; convex group = 66 ± 12.8%; P = 0.20) was similar. There was minimal loss of correction at final followup among both groups (concave group = 2.2° ±5.4°; Convex group = 1.5° ± 4.8°; P = 0.52).

Conclusion: The study results showed similar sustained satisfactory correction of flexible Lenke's type 1 scoliotic curves irrespective of the derotation maneuver used. Adequate correction, thereby restoring balance was predominantly perceived among the entire sample. Hence, convex derotation can be considered equally effective as that of concave derotation for achieving adequate correction of selective Lenke's Type-1 scoliosis.

Keywords: Adolescent idiopathic scoliosis; Scoliosis; curve correction; derotation; posterior instrumentation; spinal cord compression; spinal curvatures; spinal manipulation; vertebral column.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative, postoperative and followup anteroposterior view radiographs of a 15-year-old female patient from the concave group, showing portraying adequate sustained correction of curves
Figure 2
Figure 2
Preoperative, postoperative and followup anteroposterior view radiographs of a 16-year-old patient from the convex group, showing equally effective outcomes as that of concave group
See this image and copyright information in PMC

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