Apical vertebral derotation and translation (AVDT) for adolescent idiopathic scoliosis using screws and sublaminar bands: a safer concept for deformity correction

• Published in: European spine journal 2018-06, Vol.27 (Suppl 2), p.157-164
• Main Authors: La Maida, Giovanni Andrea, Peroni, Donata Rita, Ferraro, Marcello, Della Valle, Andrea, Vitali, Claudio, Misaggi, Bernardo
• Format: Article
• Language: English
• Subjects: Adolescent; Female; Humans; Male; Medicine; Medicine & Public Health; Neurosurgery; Original Article; Orthopedic Procedures - methods; Orthopedic Procedures - statistics & numerical data; Patients; Retrospective Studies; Scoliosis; Scoliosis - physiopathology; Scoliosis - surgery; Surgery; Surgical Orthopedics; Translation; Treatment Outcome; Vertebrae
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-018-5626-9

Purpose To assess the efficacy and safety of a new deformity correction philosophy treatment for AIS called apical vertebral derotation and translation (AVDT). Methods It is a retrospective study of prospectively collected data concerning two different scoliosis correction techniques used in our department. A total of 81 patients (22M, 59F) with a mean age of 15.5 years and minimum follow-up of 2 years were reviewed. Patients were divided into two groups according to the correction technique: 36 patients underwent single-rod derotation using all screws construct (AS), while 45 patients underwent apical vertebral derotation and translation using screws and sublaminar bands (SB). Results The mean improvement of the MT curve was 70% in the AS group and 60.6% in the SB group, while the mean improvement of the TL/L curve was 65.5 and 72.4%, respectively. PT increased in both groups after surgery with a mean amount of 2.5° in the AS group and only 1° in the SB group. We observed also a greater amount of cervical lordosis reduction in the AS group (4.5°) compared with the SB group (only 1°). The SB group had less operative time and less blood loss. Conclusion There was no significant difference between the two groups at the final follow-up and both techniques led to an excellent correction in the frontal plane; in the sagittal plane, the AVDT technique seemed to give less sagittal imbalance with better cervical profile; the surgical procedure is easy with less operative time, less blood loss and less risk of potential complications. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.