Portal de Periódicos da CAPES

Vertebral Coplanar Alignment

2008; Lippincott Williams & Wilkins; Volume: 33; Issue: 14 Linguagem: Inglês

10.1097/brs.0b013e3181788704

1528-1159

Gabriel Pizà Vallespir, Jesús Burgos Flores, I. Sanpera Trigueros, Eduardo Hevia Sierra, Pedro Doménech Fernández, Juan Carlos Rodríguez Olaverri, Manuel García Alonso, Rafael Ramos Galea, Antonio Pérez Francisco, Beatriz Rodríguez de Paz, Pedro Gutiérrez Carbonell, Javier Vicente Thomas, José Luís González López, José Ignacio Maruenda Paulino, Carlos Barrios, Óscar Riquelme García,

Pelvic and Acetabular Injuries

In Brief Study Design. Prospective multicentric study. Objective. To present the preliminary results of an innovative method for standardized correction of scoliosis, vertebral coplanar alignment (VCA), based on a novel concept: the relocation of vertebral axis in a single plane. Summary of Background Data. Normal standing spine has no rotation in coronal or transverse planes, therefore X and Z axis of vertebrae are in the same plane: they are coplanar. VCA intends to relocate these axis in one plane, correcting rotation and translation, while X axis are returned to its normal posterior divergence in sagittal plane in thoracic spine. Methods. Twenty-five consecutive adolescent idiopathic scoliosis patients (Lenke type 1) underwent posterior surgery with segmental pedicle screw fixation. Slotted tubes were attached to convex side screws. Two longitudinal rods were inserted through the end of tubes. Then, they were separated along the slots, driving the tubes into one plane, making the axis of the vertebrae coplanar and thus correcting transverse rotation and coronal translation. To obtain kyphosis, distal ends of the tubes were spread in thoracic spine. Correction was maintained by locking a definitive rod in the concave side, then tubes were retrieved and the convex side rod, inserted and tightened. Correction was assessed on preoperative and postoperative full-spine standing radiograph. Vertebral rotation was measured on computed tomography-scan and magnetic resonance imaging. Results. Preoperative average thoracic curves of 61° were corrected to 16° (73%). Preoperative average thoracolumbar curves of 39° were corrected to 12° (70%). Preoperative average thoracic apical rotation of 24° was corrected to 11° (56%). Preoperative average thoracic kyphosis of 18° remained unchanged after surgery; however, no patients had kyphosis <10° after surgery. Rib hump improved from 30 to 11 mm (65%). There were no perioperative complications. Conclusion. VCA provided excellent correction of coronal and transverse planes with normalization of thoracic kyphosis in Lenke type 1 adolescent idiopathic scoliosis surgery. Coplanar alignment, a new method for scoliosis correction, was applied to 25 AIS patients (Lenke type 1) achieving average coronal correction of 73% (thoracic) and 70% (thoracolumbar), 56% of thoracic apical rotation and 65% of rib hump correction, without lose of thoracic kyphosis, no need of thoracoplasties nor perioperative complications.