Surgical Management of Scoliosis

¹ Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York 14607

Best results in the surgical treatment of scoliosis require:

1. Conservative preoperative treatment, including the Milwaukee brace and breathing exercises which have a place in the initial treatment;

2. A knowledge of the prognosis and basic principles of treatment;

3. Adequate preoperative studies;

4. Methods of preoperative correction individualized to suit the requirements of patient and deformity;

5. Preoperative corrective casts applied by experienced personnel;

6. Stabilization of the spine by meticulous fusion;

7. A large amount of fresh autogenous iliac bone to supplement the fusion;

8. Adequate postoperative external immobilization;

9. Proper attention to details;

10. An organized program with delegated responsibility in the clinic and the community.

In addition, congenital scoliosis presents special problems in study and treatment, while paralytic scoliosis presents special problems in the stabilization of double curves and the differentiation of the types of pelvic obliquity.

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