Treatment of adolescent idiopathic scoliosis using Texas Scottish Rite Hospital instrumentation

Research output: Contribution to journalArticle

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Abstract

Study Design. To determine the effectiveness of posterior TSRH instrumentation for the treatment of idiopathic scoliosis, 103 patients with a 2-year minimum follow-up were retrospectively studied. Methods. Patients who underwent operations between October 1988 and April 1991 were evaluated for curve correction, spinal balance, and complications. Age at surgery averaged 14.3 years. Follow-up averaged 2.5 years. Results. Thoracic curve correction averaged 65% in those with King Type III/IV curves and 54% in those with Type II curves. With follow-up, correction loss averaged approximately 13% for each group. Lumbar curve correction after instrumentation in Type I and II curves averaged 48% postop but lost approximately 20% with follow-up. Trunk balance improved 77% toward midline after surgery in those with Type III/IV curves. Improvement in trunk balance was less impressive in patients with Type II curves, particularly after selective thoracic fusions. Thoracic sagittal contour improved 43% for hypokyphotic (<20°) patients but, in the remainder, no significant radiographic change was evident. No neurologic complications occurred. Delayed deep infections developed in ten patients (10%) between 11 and 45 months postoperative. Cultures eventually grew Propionibacterium acnes, staph epidermidis, or staph coagulase negative in eight patients. Two patients had pseudarthroses. Conclusions. Frontal and sagittal thoracic curve correction can be satisfactorily obtained using TSRH instrumentation. Continued efforts are being made to improve lumbar hook patterns and technique to achieve and maintain better lumbar curve correction.

Original languageEnglish (US)
JournalSpine
Volume25
Issue number6 SUPPL.
StatePublished - Mar 15 2000

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Scoliosis
Thorax
Therapeutics
Propionibacterium acnes
Pseudarthrosis
Coagulase
Nervous System
Infection

Keywords

  • Idiopathic scoliosis
  • TSRH instrumentation

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Treatment of adolescent idiopathic scoliosis using Texas Scottish Rite Hospital instrumentation. / Richards, B. Stephens; Herring, John A.; Johnston, Charles E.; Birch, John G.; Roach, James W.

In: Spine, Vol. 25, No. 6 SUPPL., 15.03.2000.

Research output: Contribution to journalArticle

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abstract = "Study Design. To determine the effectiveness of posterior TSRH instrumentation for the treatment of idiopathic scoliosis, 103 patients with a 2-year minimum follow-up were retrospectively studied. Methods. Patients who underwent operations between October 1988 and April 1991 were evaluated for curve correction, spinal balance, and complications. Age at surgery averaged 14.3 years. Follow-up averaged 2.5 years. Results. Thoracic curve correction averaged 65{\%} in those with King Type III/IV curves and 54{\%} in those with Type II curves. With follow-up, correction loss averaged approximately 13{\%} for each group. Lumbar curve correction after instrumentation in Type I and II curves averaged 48{\%} postop but lost approximately 20{\%} with follow-up. Trunk balance improved 77{\%} toward midline after surgery in those with Type III/IV curves. Improvement in trunk balance was less impressive in patients with Type II curves, particularly after selective thoracic fusions. Thoracic sagittal contour improved 43{\%} for hypokyphotic (<20°) patients but, in the remainder, no significant radiographic change was evident. No neurologic complications occurred. Delayed deep infections developed in ten patients (10{\%}) between 11 and 45 months postoperative. Cultures eventually grew Propionibacterium acnes, staph epidermidis, or staph coagulase negative in eight patients. Two patients had pseudarthroses. Conclusions. Frontal and sagittal thoracic curve correction can be satisfactorily obtained using TSRH instrumentation. Continued efforts are being made to improve lumbar hook patterns and technique to achieve and maintain better lumbar curve correction.",
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