Surgical treatmant of scoliosis using frame design

Surgical treatment results of 56 patients with dysplastic scoliosis of IV degree were analysed. Follow up period ranged from 1 to 6.5 years (mean 4.3 years). In all cases the posterior approach was used. In 22 patients (1st group) two distraction rods, similar to Harrington’s ones, were placed along both sides of the curvature, fixed to the posterior vertebral elements using end hooks and tightened between each other by wires. Posterior spondylodesis was performed using cortical allografts. In 24 patients (2nd group) and 10 patients (3rd group) the distraction rods were connected to each other by stiff transverse stays. In the 2nd group the posterior spondylodesis was performed with allografts, in the 3rd group - iliac bone autografts. No principal difference in the volume of surgical correction was noted in those groups but in the 3rd group the surgical correction was slightly higher. Operative correction loss was the highest in the 1st group (main curvature - 71%, pathologic rotation - 100%) and in the 3rd group the operative correction loss was the lowest one (25% and 80%, respectively). Authors explained those results by the advantages of stiff implanted design and the more fast reconstruction of the autografts. Authors consider that the indication to use this method is scoliosis with the 50 -70° deformity and mobile main curvature arch.