title: Effect of direct vertebral body derotation on the sagittal profile in adolescent idiopathic scoliosis.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopedic Surgery, Shriners Hospitals for Children-Philadelphia, 3551 North Broad Street, Philadelphia, PA, 19140, USA. stevenhwang@hotmail.com. stevenhwang@hotmail.com
authors.forename: Steven W
authors.initials: SW
authors.lastname: Hwang
authors.forename: Amer F
authors.initials: AF
authors.lastname: Samdani
authors.forename: Loyola V
authors.initials: LV
authors.lastname: Gressot
authors.forename: Kyle
authors.initials: K
authors.lastname: Hubler
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Marks
authors.forename: Tracey P
authors.initials: TP
authors.lastname: Bastrom
authors.forename: Randal R
authors.initials: RR
authors.lastname: Betz
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cahill
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012399:Rotation / Q000009:adverse effects; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*