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Surgical Treatment of Lenke 1 Thoracic Adolescent Idiopathic Scoliosis With Maintenance of Kyphosis Using the Simultaneous Double-Rod Rotation Technique

Sudo, Hideki MD*; Ito, Manabu MD*; Abe, Yuichiro MD; Abumi, Kuniyoshi MD*; Takahata, Masahiko MD*; Nagahama, Ken MD*; Hiratsuka, Shigeto MD*; Kuroki, Kei MD*; Iwasaki, Norimasa MD*

doi: 10.1097/BRS.0000000000000364

Study Design. Retrospective analysis of a prospectively collected, consecutive, nonrandomized series of patients.

Objective. To assess the surgical outcomes of the simultaneous double-rod rotation technique for treating Lenke 1 thoracic adolescent idiopathic scoliosis (AIS).

Summary of Background Data. With the increasing popularity of segmental pedicle screw spinal reconstruction for treating AIS, concerns regarding the limited ability to correct hypokyphosis have also increased.

Methods. A consecutive series of 32 patients with Lenke 1 main thoracic AIS treated with the simultaneous double-rod rotation technique at our institution was included. Outcome measures included patient demographics, radiographical measurements, and Scoliosis Research Society questionnaire scores.

Results. All 32 patients were followed up for a minimum of 2 years (average, 3.6 yr). The average main thoracic Cobb angle correction rate and the correction loss at the final follow-up were 67.8% and 3.3°, respectively. The average preoperative thoracic kyphosis (T5–T12) was 11.9°, which improved significantly to 20.5° (P < 0.0001) at the final follow-up. An increase in thoracic kyphosis was significantly correlated with an increase in lumbar lordosis at the final follow-up (r = 0.42). The average preoperative vertebral rotation angle was 19.7°, which improved significantly after surgery to 14.9° (P = 0.0001). There was no correlation between change in thoracic kyphosis and change in apical vertebral rotation (r =−0.123). The average preoperative total Scoliosis Research Society questionnaire score was 3.0, which significantly improved to 4.4 (P < 0.0001) at the final follow-up. Throughout surgery and even after, there were no instrumentation failures, pseudarthrosis, infection of the surgical site, or clinically relevant neurovascular complications.

Conclusion. The simultaneous double-rod rotation technique for treating Lenke 1 AIS provides significant sagittal correction of the main thoracic curve while maintaining sagittal profiles and correcting coronal and axial deformities.

Level of Evidence: 4

Radiographical findings and patient outcomes for the simultaneous double-rod rotation technique for treating Lenke 1 thoracic adolescent idiopathic scoliosis were satisfactory with the maintenance of thoracic kyphosis.

*Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan; and

Eniwa Hospital, Eniwa, Japan.

Correspondence and reprint requests to Manabu Ito, MD, PhD, Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan; E-mail:

Acknowledgment date: February 3, 2014. First revision date: March 23, 2014. Acceptance date: March 25, 2014.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work.

Relevant financial activities outside the submitted work: board membership, grants/grants pending, payment for development of educational presentations, and travel/accommodations/meeting expenses.

© 2014 by Lippincott Williams & Wilkins