Comparison between vertebral coplanar alignment and traditional correction technique: a minimal 5-year follow-up research

English Keywords:Idiopathic scoliosis  Vertebral coplanar alignment  Ｔhoracic scoliosis  Spinal fusion  Internal fixation

English Abstract:

  【Abstract】 Objectives: To evaluate the long-term outcomes of posterior vertebral coplanar alignment(VCA) surgery when compared with traditional correction technique in idiopathic thoracic scoliosis. Methods: A total of 94 idiopathic scoliosis(IS) patients undergoing posterior correction surgery between June 2008 and September 2012 were included in this study. In the VCA group, there were 42 females and 5 males with an average age of 17.9±6.5 years. The average preoperative Cobb angle was 72.8°±14.8°,　the average Risser sign was 3.7±1.5 and the average time of follow-up was 82.0±5.9 months. In the traditional technique group, there were 43 females and 4 males with an average age of 16.1±5.7 years The average preoperative Cobb angle was 75.4°±15.4°, the average Risser sign was 3.5±1.3 and the average time of follow-up was 76.0±7.2 months. The two groups were matched in terms of age, Risser sign, Cobb angle and thoracic kyphosis(TK). Operation time, blood loss and surgery-related complications were recorded. Results: For the VCA group, the mean postoperative Cobb angle was 20.7°±8.9°　with a correction rate of 71.6%. The rate of correction loss was 6.6% at the final follow-up. For the traditional technique group, the mean postoperative Cobb angle was 22.3°±7.8°　with a correction rate of 70.4%. The rate of correction loss was 5.2% at the final follow-up. There was no difference of the correction rate and correction loss between two groups(Ｐ>0.05).　For the VCA group, the TK restored from 15.8°±12.4°　to 25.8°±12.5°　at the final follow-up. For the traditional group, the TK restored from 17.8°±13.4°　to 19.3°±12.1°　at the final follow-up. There was significant difference of TK between the two groups postoperatively and at the final follow-up(Ｐ<0.05). Besides, there was no difference of operation time, blood loss or post-operative complication between the two groups. Conclusions: Compared to traditional correction technique, the VCA technique can achieve similar correction outcomes in coronal plane,　but better derotation and correction outcomes in saggital plane.