Abstract
Aimes: To give a 3D analysis of this particular deformity and to evaluate the coronal, sagittal and horizontal plane corrections in these speciþc curves. Methods: 32 patients with severe scoliosis combined with hyperrotatory paradoxic kyphosis were treated with posterior multilevel hook instrumentation. 9 patients had had preceding anterior release and fusion. The derotational maneuver could be accomplished in 21 cases. The coronal Cobb angle and the extents of apical vertebral rotation, sagittal hyper-kyphosis, upper and lower compensatory lordosis, and sagittal trunk balance were measured after an average follow-up period of 5 years and 9 months. Results: The mean coronal deformity decreased from 89.9û preoperatively to 40.7û. The mean preoperative hyperkyphosis was 70.9û in the thoracic spine, 45.9û in the thoracolumbar and 55û in the lumbar region. These values were reduced to 39.7û, 6.8û and -15û, respectively. The lateral spinal balance changed from Ð21.3 mm to Ð8.5 mm. The average rotational correction measured by the method of Jackson was 51% before, and 39% after surgery (correction: 23.5%). There was a positive correlation between the preoperative kyphosis angle and the apical rotation (r=0.58), and between the decrease of kyphosis and the correction of the rotation (r=0.67) in cases when the derotational maneuver could be accomplished. If the apex of the scoliosis and the kyphosis are on the same level, the vertebral hyperrotation is responsible for the sagittal malalignment. Satisfactory results can be achieved with posterior multilevel hook instrumentation.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
