Radiographic, clinical, and patients' assessment of segmental direct vertebral body derotation versus simple rod derotation in main thoracic adolescent idiopathic scoliosis: a prospective, comparative cohort study.

Abstract

The application of vertebral body derotation (DVBD) is still controversial by now; the purpose of this prospective cohort study was to compare comprehensive outcomes between segmental DVBD and simple rod derotation (SRD) especially in main thoracic adolescent idiopathic scoliosis. 36 patients in DVBD group and 45 patients in SRD group were with a 2-year follow-up. Among them, 19 DVBD patients and 16 SRD patients received CT scan examinations. There were no significant difference between the groups in preoperative main thoracic Cobb, apical vertebral rotation and rib hump. Apical vertebral rotation measured from CT scans was 9.7° ± 2.0° versus 15.3° ± 2.4° (p < 0.001) postoperatively in the DVBD and SRD patients, respectively. At 2-year follow-up, the main thoracic Cobb was 14.2° ± 1.6° versus 14.7° ± 1.7° (p = 0.18), rib hump was 6.4° ± 3.8° versus 6.8° ± 3.1° (p = 0.60) in DVBD group and SRD group. Patients' assessments of both groups were improved in Spinal Appearance Questionnaire (SAQ) and Scoliosis Research Society-22 Questionnaire (SRS-22), but showed no significant difference at follow-up (p = 0.47 and 0.60). Although segmental DVBD showed excellent radiographic correction of axial spinal deformity postoperatively, there was no more correction of clinical rib hump or better patients' assessment than SRD at follow-up in our data.