Comparison of different strategies on three-dimensional correction of AIS: which plane will suffer?

• DOI: 10.1007/s00586-020-06659-2
• Publication Date: 2020-12-23T15:03:00Z
• Authors: Tom P. Schlösser; Kariman Abelin-Ge...; Jelle Homans; Saba Pasha; Moyo Kruyt; Pierre Roussouly; Suken A. Shah; René M. Castelein
• Keywords: Pelvic tilt; Idiopathic scoliosis; Inflection point; Kyphosis

Abstract Purpose There are distinct differences in strategy amongst experienced surgeons from different ‘scoliosis schools’ around the world. This study aims to test hypothesis that, due 3-D nature of AIS, strategies can lead coronal, axial and sagittal curve correction. Methods Consecutive patients who underwent posterior scoliosis surgery for primary thoracic AIS were compared between three major centres ( n = 193). Patients treated according local surgical expertise: Two perform primarily an apical derotation manoeuvre (centre 1: high implant density, convex rod first, centre 2: low concave first), whereas 3 performs posteromedial translation without active derotation. Pre- postoperative shape main was analyzed using coronal angle, rotation alignment parameters (pelvic incidence tilt, T1–T12, T4-T12 T10-L2 regional kyphosis angles, C7 slope level inflection point). In addition, proximal junctional angle at follow-up compared. Results Pre-operative magnitudes similar cohorts improved 75%, 70% 59%, pre- postoperative, respectively P < 0.001). The 1 2 leads significantly more Despite kyphosis, led thoracolumbar lordosis a higher point as 3. Proximal 0.001) final follow-up. Conclusion Curve correction by may therefore risk kyphosis. Focus on plane translation, however, results residual deformity.