Outcomes of Surgical Correction of Idiopathic Scoliosis by Rod Derotation and Translation Technique - An Experience in a Tertiary Medical College Hospital

Open Access

Abstract

Background: Idiopathic scoliosis is a complex three-dimensional spinal deformity commonly affecting adolescents and often requires surgical correction in severe or progressive cases. Posterior spinal fusion using rod derotation and translation techniques has become an established method for achieving satisfactory deformity correction and spinal balance. However, limited data are available regarding the outcomes of these techniques in low-resource tertiary care settings. Aim of the study: To evaluate the radiological, functional, and clinical outcomes of surgical correction of idiopathic scoliosis using combined rod derotation and translation techniques in a tertiary medical college hospital. Methods & Materials: This prospective observational study was conducted in the Department of Orthopedic Surgery of Satkhira Medical College and Hospital and some Private Hospitals, Satkhira, Bangladesh in Bangladesh over 24 months. A total of 35 patients with idiopathic scoliosis who underwent posterior spinal deformity correction using combined rod derotation and translation techniques were included. Preoperative, operative, and postoperative clinical and radiological data were collected. Functional outcome was assessed using the Scoliosis Research Society-22 (SRS-22) questionnaire. Follow-up evaluations were performed at 3, 6, and 12 months. Statistical analysis was performed using SPSS version 26, with p<0.05 considered statistically significant. Result: The mean age of the patients was 17.9±4.6 years, and females constituted 71.43% of the study population. The mean major Cobb angle improved significantly from 61.4±11.2° preoperatively to 18.7±6.1° postoperatively and was maintained at 20.2±6.8° at 12 months (p<0.001). The mean correction rate at final follow-up was 66.9±9.1%. Significant improvement was also observed in thoracic kyphosis, coronal imbalance, and rib hump angle (p<0.001). The mean SRS-22 total score improved from 2.8±0.5 preoperatively to 4.1±0.4 at 12 months (p<0.001), with marked improvement in pain, self-image, and functional activity domains. Postoperative complications were absent in 71.43% of patients, while superficial surgical site infection was the most common complication (8.57%). Better surgical outcomes were significantly associated with younger age, smaller preoperative Cobb angle, early presentation, absence of complications, and shorter hospital stay. Conclusion: Surgical correction of idiopathic scoliosis using combined rod derotation and translation techniques providedsignificant radiological correction, improved sagittal and coronal balance, and enhanced functional outcomes with acceptable complication rates. These techniques appear to be safe and effective for managing idiopathic scoliosis in tertiary care settings of developing countries.