A Critical Analysis of Methods of Fusion for Scoliosis

An Evalutiton in Two Hundred and Sixty-Six Patients

¹ MINNEAPOLIS, MINNESOTA

Idiopathic Scoliosis

One hundred and thirty patients with idiopathic scoliosis were treated by three methods of fusion. The average gain in correction was 40 per cent. In the absence of pseudarthroses, the average gain was 43 per cent. Patients with pseudarthroses showed an average gain of 22 per cent and those with persistent defects showed an average gain of 13 per cent.

Patients rated as having a good cosmetic result showed an average gain of 45 per cent, while those rated as poor gained only 5 per cent.

Fusions performed in the early years of this series resulted in 56 per cent of defective bone grafts. The Cobb method of fusion resulted in pseudarthroses in only 7 per cent. Articular-facet fusions resulted in pseudarthrosis in 15 per cent but in the group in whom autogenous bone was added, defective grafts developed in only 7 per cent.

Paralytic Scoliosis

One hundred and thirty-six patients with paralytic scoliosis were treated in whom the average gain in correction was 44 per cent. With no pseudarthrosis present, the average gain was 47 per cent. Patients having defective grafts averaged 39 per cent gain and those with persistent defects averaged 29 per cent gain in correction.

Patients rated as having a good cosmetic result showed an average gain of 49 per cent while those with poor results showed a 4 per cent gain in correction.

Of the patients in whom early fusions were done, there were pseudarthroses in 65 per cent. Cobb-type fusions with autogenous bone added resulted in pseudarthrosis in 36 per cent, while in articular-facet fusions, there was an incidence of pseudarthrosis of 14 per cent when autogenous bone was added.

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