Posterior fusion in-situ in congenital scoliosis a study of 107 patients

Abstract

Congenital scoliosis is an abnormal curvature of the spine. In congenital scoliosis conservative or surgical treatment can be performed. In this study we analysed the results of 107 patients, retrospectively, who were operated between January 1984 - June 1995. Posterior fusion in-situ was the performed surgical treatment in all patients. Patients who were instrumented or who had kyphotic deformities were excluded. The mean angle of the curve was 52.6 degrees before the operation. W months later, after the cast was taken off there was an average of 9.8 degrees correction where as after an average of 42 months (range 24-144 months) follow-up period the mean angle correction was 9.0 degrees. According to Srirama's scala in 72% of patients the results were good, in 15.9% moderate and in 12.1% poor. Thoraco-lumbar curves and unilateral unsegmented bars have the worst prognosis. In 72% of our patients we had a solid fusion and the progression of the curve diminished. In 15.9 % of our patients fusion mass bending occured. We believe that the goal of me treatment is not to correct the deformity but to prevent the progression of the curve. So the surgical technique has to be combined with a cast application until the fusion heals.