Derotation screws provide no advantage over polyaxial screws regarding coronal & sagittal correction in thoracic curves of AIS patients,European Spine Journal

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Derotation screws provide no advantage over polyaxial screws regarding coronal & sagittal correction in thoracic curves of AIS patients
European Spine Journal ( IF 2.6 ) Pub Date : 2022-09-17 , DOI: 10.1007/s00586-022-07377-7
Ahmed Hammad ₁ , André Wirries ₁ , Johanna Eberl ₁ , Florian Geiger _{1,

2}

Affiliation

Purpose

We compared two techniques for thoracic apical derotation; one using conventional reduction screws (Single-Innie–SI) and one requiring special derotation screws that can be converted to monoaxial screws to enhance dorotation (Dual-Innie–DI) for coronal and sagittal correction and.

Methods

A total of 200 patients with thoracic AIS have been included. In the SI-Group (n = 127) the convex rod was applied first. Vertebral derotation was done by translation to the concave rod with the convex rod being in place and center of rotation (COR). In the DI-Group (n = 73) correction started with translation on the concave side as well but now followed by derotation around the concave rod using the DI-mechanism.

Results

The mean rotation according to Raimondi and coronal correction was not sig. affected (72 (± 12) % in the SI-Group versus 68 (± 15) % in the DI-Group), even when flexibility was respected (Cincinnati Correction Index CCI was 2.9 (± 4.9) versus 3.5 (± 4.4). (p < 0.01). The gain of kyphosis was sig greater (2.7°) in the SI-group, but not clinical relevant.

Conclusion

The use of DI screws for apical derotation did not provide an advantage for coronal correction or derotation in thoracic curves. Presumably after translation is performed in the DI-group, there was too much tension and friction in the construct impeding further derotation. Simultaneous translation and derotation in the SI-group, with the convex rod being the COR, yielded similar correction with better kyphosis and was faster and more economic.

中文翻译：

在 AIS 患者胸弯的冠状和矢状矫正方面，去旋螺钉与多轴螺钉相比没有优势

目的

我们比较了两种胸椎根尖去旋转技术；一种使用传统复位螺钉（Single-Innie-SI），另一种需要特殊的去旋螺钉，可以转换为单轴螺钉以增强多旋（Dual-Innie-DI），用于冠状和矢状面矫正，以及。

方法

共有 200 名胸部 AIS 患者被纳入。在 SI 组 ( n = 127) 中，首先应用凸棒。椎骨去旋转是通过平移到凹形杆，凸形杆就位和旋转中心 (COR) 完成的。在 DI 组 ( n = 73) 中，校正也开始于凹面的平移，但现在使用 DI 机制在凹面杆周围进行反旋转。

结果

根据 Raimondi 和冠状校正的平均旋转不是 sig。受影响（SI 组中 72 (± 12) % 与 DI 组中 68 (± 15) %），即使灵活性受到尊重（辛辛那提校正指数 CCI 为 2.9 (± 4.9) 与 3.5 (± 4.4)。 ( p < 0.01)。脊柱后凸的增益在 SI 组中更大 (2.7°)，但与临床无关。