Apical Derotation in the Treatment of Idiopathic Scoliosis
Wichien Laohacharoensombat MD*, Suphaneewan Jaovisidha MD**, Wiwat Wajanavisit MD*, Sorasak Suppaphol MD*
Affiliation : * Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Study
Design : A prospective study of the pedicular screw plate system in the treatment of idiopathic scoliosis.
Objectives : To study the efficacy of apical derotation of pedicular screw plate system in idiopathic scoliosis
correction and evaluate the feasibility of the technique.
Summary of Background Data: In the surgical treatment of idiopathic scoliosis, the standard technique of
fixation currently utilized the linkage of the pedicle screws via rods. Alternatively the technique of apical
correction of the deformity by sagittally contoured plates found to be a convenient and effective mean of
deformity correction and rigid fixation.
Materials and Methods : Twenty-five patients who were diagnosed as idiopathic scoliosis and underwent poste-
rior spinal fusion and fixation with pedicle screws and plates were prospectively analysed. The parameters
were compared between preoperative and postoperative by paired t-test. These parameters included Cobb
angles, body height, shoulder height difference, coronal trunk balance, hump difference and vertebral rota-
tion.
Results : There was statistically significant difference between the pre-op and post-op parameters studied.
Conclusion : The instrument can effectively correct the scoliosis of moderately severed deformity in 3 dimen-
sions especially regarding the vertebral derotation and restoration of thoracic kyphosis.
Keywords : Vertebral derotation, Scoliosis, Pedicle fixation
