The objectives of this retrospective study were to evaluate the effect of direct vertebral derotation on the sagittal alignment of the spine after selective posterior thoracic fusion for Lenke @entity196 @entity1615 ( @entity1615 ). Preservation of the sagittal alignment has become critical in the management of @entity85 . Better coronal and rotational corrections in posterior selective thoracic fusion for @entity1615 have been reported with direct vertebral derotation as compared with the simple rod rotation technique. A greater lordogenic effect has been anticipated with direct vertebral derotation; however, data comparing those two techniques in terms of correction in the sagittal plane are still lacking. Standing full-spine PA and standard lateral serial X-rays of a total of 30 consecutive @entity1 with @entity1615 treated between 2002 and 2008 at a single institution were evaluated. All the @entity1 had Lenke @entity196 curves and underwent selective posterior thoracic fusion with pedicle screw instrumentation. @entity1 who were treated with additional osteotomies and concave or convex thoracoplasty or concomitant anterior releases were excluded. Minimum follow-up period was 24 months. Preoperative and postoperative coronal and sagittal spinal alignments in both the groups were compared. In 13 @entity1 , the correction was achieved by means of a simple rod rotation (SRR). In 17 @entity1 , the technique of direct vertebral derotation (DVD) was used. @entity1635 correction averaged 67 and 69%, respectively, and was similar in both groups (p > 0.05). @entity1513 and @entity1515 remained unchanged in the SRR group (p > 0.1). In the direct vertebral derotation group, a significant decrease of both @entity1513 and @entity1515 of 8.1   and 11.8  , respectively, was observed (p < 0.0001). Global sagittal balance remained within normal limits in all the @entity1 at the latest follow-up. @entity1513 and @entity1515 should be taken into account when using direct vertebral derotation for selective posterior thoracic fusion in @entity1615 . In order to preserve sagittal alignment in these @entity1 , ultra hard rods or maneuvers that pull posteriorly the concave side of the spine, thus avoiding the application of additional flattening forces should be considered.

Selective posterior thoracic fusion by means of direct vertebral derotation in XXXX : effects on the sagittal alignment.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1615 :: ('OMIM:181800', 'Disease') :: ['AIS', 'adolescent idiopathic scoliosis'] @entity1513 :: ('MESH:D007738', 'Disease') :: ['Thoracic kyphosis', 'Decrease in thoracic kyphosis', 'thoracic kyphosis'] @entity1635 :: ('MESH:D012600', 'Disease') :: ['Scoliosis'] @entity196 :: ('MESH:D020754', 'Disease') :: ['Type I'] @entity1515 :: ('MESH:D008141', 'Disease') :: ['lumbar lordosis'] @entity85 :: ('MESH:D009140', 'Disease') :: ['spinal deformity']
@entity1615 :: (OMIM:181800,Disease) :: ['adolescent idiopathic scoliosis']
