The Journal of Bone and Joint Surgery, Vol 77, Issue 8 1210-1216, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Adolescent idiopathic scoliosis. Long-term effect of instrumentation extending to the lumbar spine
PJ Connolly, HP Von Schroeder, GE Johnson and JP Kostuik
Toronto Hospital for Sick Children, Ontario, Canada.
We evaluated eighty-three patients in whom adolescent idiopathic scoliosis
had been treated with a posterior spinal arthrodesis and Harrington
instrumentation extending to the second, third, fourth, or fifth lumbar
vertebra. All eighty-three patients completed a questionnaire, and
fifty-five patients were also examined clinically and roentgenographically
at a follow-up evaluation at an average of twelve years (range, ten to
sixteen years). Twelve patients had a type-I curve; twenty-six, a type-II
curve; sixteen, a type-III curve; and one, a type-IV curve, according to
the classification of King et al. The preoperative Cobb angle of the
primary curve averaged 60 degrees and ranged from 40 to 100 degrees. The
curve was an average of 35 degrees (range, 15 to 65 degrees) at the most
recent follow-up evaluation. Functional assessment with use of information
from the questionnaire revealed an average spine score of 81 points (range,
18 to 99 points). On the basis of the score, thirty-five patients were
considered to have had an excellent result; twenty, a good result;
thirteen, a fair result; and fifteen, a poor result. Sixty-three (76 per
cent) of the eighty-three patients had low-back pain compared with thirty
(50 per cent) of sixty individuals who served as a control group. This
difference was significant (p < 0.001; chi-square test). Eighteen
patients (22 per cent) needed additional spinal procedures. Fourteen
patients (17 per cent) did not think that the goals of the initial
operation had been accomplished.(ABSTRACT TRUNCATED AT 250 WORDS)
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