Effect of direct vertebral body derotation on the sagittal profile in adolescent idiopathic scoliosis.

Purpose: We sought to clarify the effect of applying derotation maneuvers in the correction of adolescent idiopathic scoliosis (AIS) on the sagittal plane.

Methods: We retrospectively queried a large, multicenter, prospectively collected database for patients who underwent surgical correction of AIS. All patients had at least 2 years of follow-up and documentation as to whether or not a derotation maneuver was performed during surgery. All patients underwent posterior spinal fusion with pedicle screw constructs. Patients who underwent concurrent anterior procedures were excluded.

Results: A total of 323 patients were identified, of whom 66 did not have direct vertebral body derotation (DVBD) maneuvers applied during the deformity correction. The remaining 257 had a vertebral body derotation maneuver performed during their surgical correction. Although no significant differences were identified between the two groups when comparing pre-op and post-op thoracic kyphosis using T2-12 and T5-12 endplates, the absolute change in angulation measured from T2-12 was significantly different between the two groups. Postoperatively, the derotation group had a mean decrease in thoracic kyphosis of 5.1±15.3° as compared to 10.8±18.9° in the control group, P = 0.03.

Conclusion: Although patients in both groups had decreased mean thoracic kyphosis postoperatively, application of DVBD in the correction of scoliosis did not additionally worsen the sagittal profile.