Surgical treatment of double thoracic XXXX with a rigid proximal thoracic curve.

@entity1 @entity2003 @entity1615 @entity1513 @entity1515 @entity717 @entity85
PURPOSE: There is limited consensus on the optimal surgical strategy for double thoracic @entity1615 ( @entity1615 ). Recent studies have reported that pedicle screw constructs to maximize scoliosis correction cause further thoracic spine @entity1515 . The objective of this study was to apply a new surgical technique for double thoracic @entity1615 with @entity2003 and assess its clinical outcomes. METHODS: Twenty one consecutive @entity1 with Lenke 2 @entity1615 and a rigid PT curve (Cobb angle >= 30   on side-bending radiographs, flexibility  <=30 %) treated with the simultaneous double-rod rotation technique (SDRRT) were included. In this technique, a temporary rod is placed at the concave side of the PT curve. Then, distraction force is applied to correct the PT curve, which reforms a sigmoid double thoracic curve into an approximate single thoracic curve. As a result, the PT curve is typically converted from an apex left to an apex right curve before applying the correction rod for PT and main thoracic curve. RESULTS: All @entity1 were followed for at least 2 years (average 2.7 years). The average main thoracic and PT Cobb angle correction rate at the final follow-up was 74.7 and 58.0 %, respectively. The average preoperative T5-T12 thoracic kyphosis was 9.3  , which improved significantly to 19.0   (p < 0.0001) at the final follow-up. Although 71 % @entity1 had preoperative level shoulders or a positive radiographic shoulder height, all @entity1 had mildly imbalanced or balanced shoulders at the final follow-up. The average preoperative main thoracic apical @entity717 angle of 20.7   improved significantly after surgery to 16.4   (p = 0.0046), while the average preoperative total SRS questionnaire score of 3.7 improved significantly to 4.4 (p = 0.0012) at the final follow-up. CONCLUSIONS: Radiographic findings and @entity1 outcomes were satisfactory. @entity1513 can be maintained or improved, while coronal and @entity85 can be corrected using SDRRT for Lenke 2 @entity1615 with a rigid PT curve.
