Harrington and Cotrel-Dubousset Instrumentation in Adolescent Idiopathic Scoliosis

Primary thoracoplasty and pedicle screw instrumentation in thoracic idiopathic scoliosis

“…In King II curves there was 54% improvement of the compensatory lumbar curves, from 39 (30-45°) to 17.8°(10-25°) at the last follow up. The average clinical rib hump of this group was 12.2°( 8-14) preoperatively and 7.6° (5)(6)(7)(8)(9)(10)(11)(12) at the last follow up. This represented a spontaneous improvement of 37%.…”

“…The average total score of the questionnaire was 89 (40-112) out of a maximum of 120 possible points. For the subscore pain 25 (1-35), for the general self-image 12 (7)(8)(9)(10)(11)(12)(13)(14)(15), for the postoperative self-image 10 (4-15) and for the postoperative function 6 (2-10) points were determined. The score for the function from the back condition and the level of activity were 11 (6-13) and 12 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), respectively and in patients satisfaction an average score of 12 (6-15) was achieved.…”

“…The total score of the SRS-24 questionnaire (n=17) was 96 (66-112). The subscores were as follows: pain 29 (20-34), the general self-image 12 (9)(10)(11)(12)(13)(14)(15), the postoperative self-image 11 (9)(10)(11)(12)(13)(14), the postoperative function 6 (2-10), the function from the back condition 13 (9)(10)(11)(12)(13)(14)(15), the level of activity 13 (5-15) and the patient's satisfaction 12 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15) points. For the total score and in all the subscores the differences between the thoracoplasty group and the control group were not statistically significant.…”

“…In their series Harrington rod distraction had little effect of the rib hump deformity despite improvement of the Cobb angle. With the introduction of the CD instrumentation it was possible to obtain multidirectional correction of the spine but the rib hump deformity was not corrected [9] and could be addressed only by thoracoplasty [19]. Harvey suggested a primary thoracoplasty in patients instrumented with the CD instrumentation when the rib prominence exceeds 15° [ 8].…”

“…Average Risser stage was 3 (0-5). In the control group a total of 202 pedicle screws were inserted, the average number of pedicle screws per patient being 9.6 (8)(9)(10)(11)(12) and the average number of segments fused 8.6 (7-10). The lowest level of instrumentation was L2 in four, L1 in five, T12 in nine, and T11 in three patients.…”