Comparison of Long-Term Functional and Radiologic Outcomes After Harrington Instrumentation and Spondylodesis in Adolescent Idiopathic Scoliosis

Abstract

In patients with adolescent idiopathic scoliosis who undergo surgery with Harrington instrumentation, the overall long-term clinical outcome does not correlate with the radiologic outcome. However, a significant inverse correlation was found between the magnitude of the primary thoracic curve at follow-up assessment and the scores for questions on cosmetic matters in the Scoliosis Research Society questionnaire. Spine mobility is diminished as a result of spondylodesis, but the patients perform, on the average, as well as the normal population in nondynamometric trunk strength measurements.

Low back pain after spinal fusion and Harrington instrumentation for idiopathic scoliosis

“…Whereas the studies of Danielsson et al [4] with a follow-up of 23 years and a significantly reduced quality of life compared with age matched individuals, the good results of our study and others [7][8][9]13] may be related to the shorter follow-up and the smaller study group. Padua [14] for example, could only locate 38% of patients but with a follow-up assessment of 37.5 years.…”

“…However, such information has proved to correlate only weakly with outcomes that are more relevant to patients. Until recently, only a few long-term outcome studies have used standardized and validated patient-oriented tools to evaluate surgically treated patients with idiopathic scoliosis [1,3,4,[7][8][9].…”

Minimum 10 years follow-up surgical results of adolescent idiopathic scoliosis patients treated with TSRH instrumentation

“…Williers et al reported 40% final correction rate in a 10.8 years follow-up study [47]. Helenius et al reported relatively lower correction rates with Harrington rod system when compared with the C-D instrumentation [24]. Lespien stated that in 2 years following the operation.…”

“…Most of the long-term results in the literature are with the Harrington rod system [23,24,32,47]. Williers et al reported 40% final correction rate in a 10.8 years follow-up study [47].…”

“…These studies also report that Harrington rod system has comparable clinical and radiological results with the modern instrumentation systems, however, the final deformitycorrection rates are very small and the overall lifequality at the last follow-up visit is almost unchanged when compared with the third-generation instrumentation systems [17,21,23,24,26,31,32,47]. Long-term results with the modern systems are limited [5,21,23,26,29,33].…”