THE CONSERVATIVE COMPENSATION-DEROTATION TREATMENT OF SCOLIOSIS

¹ Department of Orthopaedic Surgery, State University of Iowa Hospitals, Iowa City

1 . Compensation of the scoliosis is a necessary prerequisite for maintenance of correction and posture.

2. The combined compensation-derotation method is adequate to obtain compensation in suitable cases and leads to definite maintenance of posture.

3. The rotary deformity of the thoracic spine cannot be corrected at present. Attempts to correct the thoracic deformity by rotation to the concave side are preposterous. The thorax is already rotated to the concave side in relation to the spinal column, and such attempts only make the situation worse.

4. Derotation is directed toward the lumbar and cervicothoracic section of the spine, and, by limbering up these sections, aids in the development of adequate counter curves.

5. If the compensation can be accomplished without forcible cast correction, and provided muscle development is adequate, the spine need not be fused. However, if the compensation must be forced by a cast, fusion will become necessary to hold the correction obtained.

6. Failure must be expected, with or without fusion, when compensation is lost or not obtained. Only a few cases at the end of the growth period hold the correction when decompensated.

7. Failure must also be expected in the absence of adequate muscle development, unless fusion is performed.

8. Compensation-derotation plus adequate muscle development promises success in the great majority of all non-paralytic cases.

9. Adequate compensation-derotation plus fusion in the presence of inadequate musculature, likewise, holds out promise of success in all paralytic and many congenital cases.

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