Vertebral Coplanar alignment for correction of thoracic scoliosis: techniques and results / 中华骨科杂志

ABSTRACT

Objective To prospectively explore the techniques and correction results of the method of vertebral coplanar alignment (VCA) in posterior correction for thoracic scoliosis. Methods Between June 2008 to March 2009, 27 patients with idiopathic thoracic scoliosis were selected to undergo posterior pedicle screw fixation with assistance of Coplanar system. There were 26 females and 1 male with the average age of 15.9 years(ranged 11-23 years). There were type 1 in 25 cases and type 2 in two cases. The levels of fusion were established according to the Lenke criteria. The average preoperative coronal Cobb angle was 49°(ranged 40°-70° ). During the procedure, the pedicle screws were inserted in each involved levels on the convex side, an extended Coplanar tube was screwed in line with screw axis to each screws. Then two rigid bars were inserted through the uppermost part of the slotted tube sequentially. As the bar was gently driven down toward the bottom end, the pedicle screws axis started to converge in the straight line, correcting translation and rotation. Spacers were inserted into the slots of the tubes to achieve the ideal physiologic thoracic kyphosis. Once the rod was fixated in the concave side of the main curve, the Coplanar system could be removed. Results The mean postoperative Cobb angle was 14° (ranged 6°-25°), representing the correction rate of 70.7%. The average duration of surgery was 245 min (ranged 210-300 min) and a mean estimated blood loss was 1500 ml (ranged 600-2100 ml). The duration of follow-up averaged 15 (12-18) months. The loss of correction at last follow-up was 3° with the loss of correction rate of 6.1%. In the sagittal plane, the thoracic kyphosis was restored from 18° to 25°. No coronal or sagittal plane decompensation occurred. No thoraeoplasties were necessary to correct the residual rib hump. There was no death, infection and neurological complications. Conclusion The Coplanar is a new technique for the correction of scoliosis, its advantage lies in excellent and modulatable three-dimensional correction with a single and standardized maneuver.