title: Vertebral Derotation by Vertebral Column Manipulator Improves Postoperative Radiographs Outcomes of Lenke 5C Patients for Follow-up of Minimum 2 Years.
abstract: METHODS
  This was a retrospective study.
  
  
  OBJECTIVE
  The aim of this study was to compare radiographic outcomes of Lenke 5C adolescent idiopathic scoliosis (AIS) patients treated by vertebral column manipulator (VCM) or simple rod derotation (SRD) maneuver.
  
  
  BACKGROUND
  The direct vertebral rotation (DVR) technique has demonstrated better rotational and coronal correction than SRD, but clinical radiographic outcomes for Lenke 5C AIS following DVR using a VCM derotational device have not been described.
  
  
  METHODS
  A retrospective study was carried out in 39 Lenke 5C AIS patients treated by VCM (n=20) or SRD (n=19) techniques between April 2008 and June 2011. All patients had complete clinical record and radiographic data. Nine radiographic variables were collected and compared at 3 time points (preoperative, immediate postoperative, and minimum 2-year follow-up) between both groups.
  
  
  RESULTS
  Scoliosis was successfully corrected in both groups. All patients obtained good coronal and sagittal balance, and no severe complications occurred. The postoperative apical rotation corrective rate of the VCM and SRD groups were 55.1% and 25.5%, respectively (P < 0.05). Lowest instrumented vertebra and stable vertebra (LIV-SV) was statistically significant between the VCM and SRD groups, the mean values were 1.2 ± 0.4 level and 0.7 ± 0.5 level (P < 0.05). The main curve corrective rates and LIV-tilt angle correction rates were not significantly different between groups, but it showed a spontaneous correction for the coronal LIV-tilt angle for both groups at the last follow-up.
  
  
  CONCLUSIONS
  VCM improved postoperative apical axial rotational correction and lessened the lumbar fusion segment compared with the SRD technique, which might have a potential trend to reserve lumbar mobility.
authors.affiliation: *Department of Anatomy, Guangdong Provincial Medical Biomechanical Key Laboratory, Southern Medical University†Department of Spine Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Zifang
authors.initials: Z
authors.lastname: Huang
authors.forename: Qifei
authors.initials: Q
authors.lastname: Wang
authors.forename: Junlin
authors.initials: J
authors.lastname: Yang
authors.forename: Jingfan
authors.initials: J
authors.lastname: Yang
authors.forename: Fobao
authors.initials: F
authors.lastname: Li
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008141:Lordosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008297:Male; D020393:Manipulation, Spinal / Q000295:instrumentation*; D011184:Postoperative Period; D012399:Rotation; D013131:Spine / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*