title: Vertebral coplanar alignment technique: a surgical option for correction of adult thoracic idiopathic scoliosis.
abstract: OBJECTIVE
  Previous studies have demonstrated vertebral coplanar alignment (VCA) as an effective surgical option for adolescent idiopathic scoliosis (AIS). The purpose of this study is to analyze the outcome of VCA for the surgical correction of adult idiopathic scoliosis (AdIS).
  
  
  METHODS
  35 AdIS patients (mean age: 24.2 years) undergoing VCA-instrumentation were reviewed. The main thoracic curve and thoracic kyphosis (TK, T5-T12) were evaluated preoperatively, immediate postoperatively, and at the final follow-up (>1 year). All patients were stratified by the TK modifier before surgery: "+" (TK, >40°), "-" (TK, <10°), and "N" (TK, 10°-40°) for normal. The apical vertebral body-to-rib ratio (AVB-R), rib hump (RH), and rotational angle to sacrum (RAsac) were measured to assess the correction of rotational deformity. Quality of life was evaluated with SRS-20 questionnaires.
  
  
  RESULTS
  The main thoracic curve (59.1° vs. 19.3°, P < 0.001) and rotational deformity (AVB-R: 2.4 vs. 1.7 %, P < 0.001, RH: 34.9 vs. 19.1 mm, P < 0.001, RAsac: 19.6° vs. 11.9°, P < 0.001) were significantly reduced with surgery. Sagittal deformity improved significantly in group "+" (51.4° vs. 31.6°, P < 0.001) and group "-" (6.2° vs. 20.1°, P < 0.001), while no significant postoperative change in TK was observed in group "N" (23.5° vs. 26.3°, P = 0.270). Patients were followed for an average of 18.7 months with no significant loss of correction. SRS scores improved greatly from 57.7 preoperatively to 71.6 at the final follow-up.
  
  
  CONCLUSIONS
  VCA can be effectively used for the correction of the coronal and rotational deformity, with better sagittal profile restoration in adult thoracic idiopathic scoliosis with sagittal malalignment.
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Shouyu
authors.initials: S
authors.lastname: He
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Hongda
authors.initials: H
authors.lastname: Bao
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Zezhang
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China. gulouspine@gmail.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Hengcai
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Zhongshan Rd 321, Nanjing, 210008, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D065289:Pedicle Screws; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
keywords: Idiopathic scoliosis; Thoracic kyphosis; Vertebral coplanar alignment