Yonsei Med J.  2010 Sep;51(5):753-760. 10.3349/ymj.2010.51.5.753.

Video-Assisted Thoracoscopic Surgery for Correction of Adolescent Idiopatic Scoliosis: Comparison of 4.5 mm versus 5.5 mm Rod Constructs

• Kim HS
• Park JO
• Nanda A
• Kho PA
• Kim JY
• Lee HM
• Moon SH
• Ha JW
• Ahn EK
• Shin DE
• Kim SJ
• Moon ES

• KMID: 1071429
• DOI: http://doi.org/10.3349/ymj.2010.51.5.753

Abstract

PURPOSE
The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS).
MATERIALS AND METHODS
Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis.
RESULTS
The major curve was corrected from 49.8degrees and 47.2degrees pre-operatively to 24.5degrees and 18.8degrees at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group.
CONCLUSION
Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction.

Keyword

Instrumentation; rod; scoliosis; thoracoscopic surgery

MeSH Terms

Adolescent
Adult
*Bone Screws
Female
Humans
Male
Retrospective Studies
Scoliosis/radiography/*surgery
Thoracic Surgery, Video-Assisted/*methods
Treatment Outcome

Figure

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  Fig. 1 Radiographs of the spine in a patient instrumented with thin 4.5 mm diameter rod. (A) Pre-operative anteroposterior radiograph. (B) Immediate post-operative anteroposterior supine radiograph. (C) The anteroposterior standing radiograph made thirty months after surgery, showing the large degree correction loss compared to immediate post-operative radiograph.

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  Fig. 2 Radiographs of the spine in a patient instrumented with thick 5.5 mm diameter rod. (A) Pre-operative anteroposterior radiograph. (B) Immediate post-operative anteroposterior supine radiograph. (C) The anteroposterior standing radiograph made thirty-eight months after surgery, showing no loss of correction compared to immediate post-operative radiograph.

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