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Concepts of Differently Shaped Rods Translation and Direct Vertebral Rotation for the Surgical Treatment of Adolescent Idiopathic Scoliosis: From Bench to Bedside

February 10, 2018

Contributors: Raffaele Borghi, MD; Mohammadreza Chehrassan, MD; Luca Cristofolini, PhD; Marco Palanca, PhD; Fabrizio Perna; Alberto Ruffilli, MD, PhD; Niccolò Stefanini, MD; Angelo Toscano, MD; Francesco Traina, MD, PhD; Cesare Faldini, MD; Cesare Faldini, MD

2018 AWARD WINNER Adolescent idiopathic scoliosis is a three-dimensional deformity with frontal, sagittal, and axial impairment. The purpose of surgical management is to correct the deformity, obtaining a stable, balanced spine. Mobile segments of the lumbar spine should be preserved, if possible, with restoration of good clinical alignment in all three planes. Frontal plane correction is no longer the most challenging aspect of management because of outstanding technological improvements in the available instruments; however, sagittal and axial alignment restoration remains difficult to achieve. Direct vertebral rotation is the most effective maneuver for axial deformity correction. In addition, indirect vertebral rotation techniques may help improve axial correction, allowing for good sagittal and frontal contour. A vertebral translation technique in combination with the use of two differently shaped rods aids in rib hump deformity reduction and kyphosis restoration if performed with frontal plane correction. If used correctly, the differently shaped rods translation technique acts as a three-dimensional corrective maneuver. This video schematically describes the concept of differently shaped rods translation and direct vertebral rotation for the surgical management of adolescent idiopathic scoliosis.