Adolescent idiopathic scoliosis. Correction of vertebral rotation with use of Wisconsin segmental spinal instrumentation.

We retrospectively reviewed the results of use of Wisconsin segmental spinal instrumentation in twenty-four patients who had adolescent idiopathic scoliosis. Our purpose was to determine whether there had been any correction of the rotational component. The mean age at the time of the operation was thirteen years and eight months (range, eleven to seventeen years). Computerized tomography was used to measure the degree of vertebral rotation relative to the midline of the body and relative to the mid-sagittal plane in thirty curves that had been treated with instrumentation and in fifteen that had not. According to the criteria of King et al., five patients had a type-I curve; fourteen, a type-II curve; four, a type-III curve; and one, a type-V curve. The mean correction in the coronal plane was 23 degrees (43 per cent; range, 20 to 69 per cent) for the curves that had been treated with instrumentation and 15 degrees (35 per cent; range, 11 to 77 per cent) for those that had not. The mean derotation of the apical vertebra, in relation to the midline of the body, in twenty-two curves that had been treated with instrumentation and that had had a mean initial rotation of 26 degrees (range, 8 to 53 degrees) was 6 degrees (range, 1 to 29 degrees). For seven curves, with a mean initial rotation of 25 degrees (range, 21 to 35 degrees), rotation increased a mean of 3 degrees (range, 1 to 7 degrees) after instrumentation. The rotation of the apical vertebra did not change in one curve treated with instrumentation. Derotation was seen in twelve of the fifteen curves that had not been treated with instrumentation.