Interdisciplinary Neurosurgery (Jun 2021)
Improving effects of vertebral column manipulator on lower instrumented vertebrate tilt and lumbar mobility of lenke 5C patients for follow-up of minimum 2 years
Abstract
Objective: To compare the lower instrumented vertebra (LIV) related parameters and lumbar function in the long-term follow-up of Lenke 5C adolescent idiopathic scoliosis patients treated with vertebrate column manipulator (VCM) or simple rod derotation (SRD) maneuver. Methods: 43 Lenke 5C patients treated with VCM or SRD maneuver were retrospectively enrolled without randomization. The clinical and radiographic data were completely documented. Thorough comparisons of relevant variables were performed at three different time points (preoperative, immediately postoperative, 2-year follow-up) between the two groups. Results: The curvatures of all patients were satisfactorily corrected with good sagittal achieved. No severe postoperative complications occurred. The postoperative LIV rotation of VCM group was significantly smaller than SRD group (7.12° ± 4.16° vs 11.64° ± 5.40°, P < 0.01). The LIV-tilt of VCM group were significantly better improved immediately after surgery (5.58° ± 3.60° vs 7.96° ± 5.89°, P = 0.021) and at 2-year follow-up (4.78° ± 3.11° vs 8.59° ± 5.51°, P < 0.01). Meanwhile, there was a spontaneous improvement of postoperative LIV-tilt in VCM group but an aggravation in SRD group. The relevant parameters that correlated with LIV-tilt were postoperative LIV rotation (r2 = 0.336, P < 0.001), 2-year LIV rotation (r2 = 0.410, P < 0.001) and 2-year coronal imbalance (r2 = 0.282, P < 0.001). In addition, VCM group conserved more lumbar mobility (46.90° ± 17.34° vs 30.91° ± 14.27°, P < 0.01). Conclusions: VCM system on Lenke 5C patients could improve the LIV rotation, LIV-tilt and the risk of trunk decompensation and distal adding-on more efficaciously than SRD maneuver in follow-up, as well as conserving more lumbar mobility.
