Reversing the concept: correction of adolescent idiopathic scoliosis using the convex rod de-rotation maneuver.

ABSTRACT

PURPOSE: To show the radiological results of adolescent idiopathic scoliosis (AIS) patients treated with posterior fusion using all-pedicle-screw construct with correction carried out using a convex rod reduction technique. METHODS: Between October 2004 and June 2007, 42 AIS patients were treated with posterior fusion using all-pedicle-screw construct with correction done through the convex side. Two patients were lost to follow-up and were not included in the study. Forty patients had a minimum follow-up of 2 years. Patients were evaluated for the deformity correction in coronal and sagittal planes and for spinal balance. RESULTS: The mean preoperative Cobb angle of the major curve and secondary minor curves was 60° and 41°, respectively. Immediate postoperative mean Cobb angle of the major curve and secondary minor curves was 17° and 13°, respectively. Postoperative 2-year average major curve loss of correction was 7 %. Postoperative 2-year average minor curve loss of correction was 5 %. Preoperative thoracic kyphosis of 28° was changed to 22° in 2-years follow-up. The loss of thoracic kyphosis was most noted in hyperkyphotic patients. CONCLUSIONS: The correction of AIS by convex-sided pedicular screws yields a coronal correction comparable to what is described in the literature for segmental concave-sided screws.