Affiliations: [a] Head of the Spine Group, Hospital do Servidor Público Estadual (HSPE), São Paulo, Brazil | [b] Member of the Spine Group, Hospital do Servidor Público Estadual (HSPE), São Paulo, Brazil | [c] Clinical Rehabilitation Center in Scoliosis, Campinas, São Paulo, Brazil | [d] Health Science Post-Graduate Department, Medical School, University Santo Amaro, São Paulo, Brazil | [e] Medical School, University of São Paulo, São Paulo, Brazil
Correspondence:
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Corresponding author: Ana Paula Ribeiro, Post-Graduate Department, School Medicine, University of São Paulo, Cipotânea, 51, Campus Universitário, São Paulo, SP 05360-160, Brazil. E-mails: apribeiro@usp.br or anapaulafisioterapia@yahoo.com.br.
Abstract: BACKGROUND: Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal and sagittal) of adolescents with idiopathic scoliosis (AIS) pre- and post-surgery with direct vertebral rotation (DVR), associated with type 1 osteotomies in all segments (except the most proximal) and type 2 in the periapical vertebrae of the curves. METHODS: A prospective study design was employed in which 41 AIS were evaluated and compared pre- and post-surgery. Scoliosis was confirmed by a spine X-ray exam (Cobb angle). Eight radiographic parameters were measured: Cobb angles (thoracic proximal and distal), segmental kyphosis, total kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. RESULTS: The Cobb angle averaged 51.3∘± 14.9∘. Post-surgery, there were significant reductions for the following spine measurement parameters: Cobb angle thoracic proximal (p= 0.003); Cobb angle thoracic distal (p= 0.001); Cobb angle lumbar (p= 0.001); kyphosis (T5-T12, p= 0.012); and kyphosis (T1-T12, p= 0.002). These reductions showed the effectiveness of surgical correction to reduce Cobb angles and improve thoracic kyphosis. The values obtained for lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt were not significantly different pre- and post-surgery. CONCLUSION: The surgical technique of DVR in AIS proved to be effective in the coronal and sagittal parameters directed at Cobb angles and thoracic kyphosis in order to favor the rehabilitation process.
