PREOPERATIVE AND POSTOPERATIVE MEASUREMENT OF VERTEBRAL ROTATION WITH CT IN IDIOPATHIC SCOLIOSIS
Journal Title: Journal of Turkish Spinal Surgery - Year 1996, Vol 7, Issue 1
Abstract
Many different methods have been described at the measurement of spinal rotation in idiopathic scoliosis. Measurement of rotation with computarized tomography is a considerably new method when compared to Moe and Pedriolle method. We performed spinal instrumentation with TSRH and ALICI systems to 26 cases with idiopathic scoliosis at the Orthopaedics and Traumatology Department of Gülhane Miiitary Medical Academy between January 1991 and November 1995 but we measured spinal rotation with CT in 16 patients preoperative and postoperatively. Thirteen (81.25%) of the cases were female and 3 (18.75%) were male. While determining spinal rotation with CT, two different measurements; RAml and RAsag were used as described byAaro and Dahlborn in 1981 (1, 2). Statistical analysis of the data was made and we observed that we could be able to make a rotational correction about 28% in apical vertebra. While the lateral inclination in frontal plane is easily corrected in scoliosis surgery, the correction rate of the other important components of scoliosis namely inclination in sagittal plane and rotation in axial plane are valuable criterias in evaluation of the success of the surgical treatment. We observed that the rotation of concave rod to 90 degrees at time of correction did not completely reflect to the apical vertebrae. Sublaminar vviring or double hook (claw) application to apical vertebrae are the options for more correction in rotation at the çenter of scoliosis. An-other option is to apply 90 degrees rotation to concave rod two times first with slight distraction, second with full distraction. Since the pedicle shadows are obstracted by the metallic implant postoperatively, the measurement of verte-bral rotation could not be possible wı'th Nash and Moe method. İn contrary, the CT establishes the remarkable are-as clearly and distortion of the images are no longerproblems with new technolog, so CT does measurements more accurately. İn conciusion, CT is a reliable method for measuring spinal rotation.
Authors and Affiliations
C. SOLAKOĞLU, M. ALTINMAKAS, N. AYDOĞAN, M. TAŞAR, A. ŞEHİRLİOĞLU, G. MOLLA
Keywords
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