Effect of different occasions of posterior thoracoplasty on derotation of thoracic apical and adjacent segmental vertebrae in KingⅡscoliosis patients

Yin Hai-dong1, Huang Ming-guang1, Peng Yan2, Su Pei-qiang2, Du Qing-jun1, Du Kai-li2, Wang Xin-guang2, Huang Dong-sheng2

1Department of Spine Surgery, Shunde People’s Hospital, Foshan   528300, Guangdong Province, China; 2Department of Orthopaedics, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou   510120, Guangdong Province, China

Yin Hai-dong★, Master, Attending physician, Department of Spine Surgery, Shunde People’s Hospital, Foshan   528300, Guangdong Province, China
yhd76805@126.com

Correspondence to: Huang Dong-sheng, Tutor of doctor, Professor, Chief physician, Department of Orthopaedics, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou   510120, Guangdong Province, China
huangdongshen18@
hotmail.com 

Supported by: the National Natural Science Foundation of China, No. 30700456*

Received: 2007-10-13
Accepted: 2008-01-28

Abstract
BACKGROUND: With the proposing of three dimensional correction theory of spinal column, thoracoplasty has been paid more attention. Posterior convex thoracoplasty can be performed before or after scoliosis correction.
OBJECTIVE: To study the effect of posterior thoracoplasty on different occasions on derotation of thoracic apical and adjacent segmental vertebrae in King Ⅱscoliosis.
DESIGN, TIME AND SETTING: The control case experiment was performed at the Second Hospital Affiliated to Sun Yat-sen University from January 2000 to July 2007.
PARTICIPANTS: Totally 26 cases of King Ⅱscoliosis (ⅡA 10 cases,ⅡB 16 cases), who underwent all pedicle screws correction and convex thoracoplasty at the Second Hospital Affiliated to Sun Yat-sen University, were enrolled in this study.
METHODS: Patients were divided into two groups. Twelve patients in the pre-derotation group received convex thoracoplasty before derotation, whereas fourteen patients in the post-derotation group received convex thoracoplasty after derotation. Surgery mode was posterior pedicle screw fixation. Apical and adjacent segmental vertebrae were fixed by universal screw. Derotation was conducted by CD technique. None of a patient received anterior release.
MAIN OUTCOME MEASURES: Major thoracic curve Cobb angle, apical and adjacent segmental vertebrae derotation angle were compared between the two groups by rank-sum test.
RESULTS: The thoracic Cobb angle correction rate in two groups had no significant difference (P=0.17). Apical and adjacent segmental vertebrae derotation rate in pre-derotation group was much higher than that in post-derotation group (21.4%, 15.1%, P=0.026).
CONCLUSION: Convex thoracoplasty before posterior derotation can improve the derotation effect for King Ⅱ scoliosis on apical and adjacent segmental vertebrae.

Yin HD, Huang MG, Peng Y, Su PQ, Du QJ, Du KL, Wang XG, Huang DS. Effect of different occasions of posterior thoracoplasty on derotation of thoracic apical and adjacent segmental vertebrae in KingⅡscoliosis patients.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(28):5549-5553 [www.zglckf.com/zglckf/ejournal/upfiles/08-28/28k-5549(ps).pdf]