title: Results of spinal instrumentation of adolescent idiopathic scoliosis by King type.
abstract: The purpose of this study is to determine the usefulness of the King classification in predicting decompensation in adolescent idiopathic scoliosis. Fifty-one patients were reviewed with a mean follow-up of 25 months. Five patients had Type 1 adolescent idiopathic scoliosis: four were treated with Zielke/Cotrel-Dubousset instrumentation or Zielke instrumentation alone. Correction was greater than 51% in these cases and there was no decompensation. Twenty-three patients had Type II scoliosis. Nineteen of whom were treated with Cotrel-Dubousset instrumentation; 3 with Zielke and Cotrel-Dubousset instrumentation, and 1 with Zielke. The best correction occurred with anterior/posterior instrumentation. Decompensation occurred in 9 patients, all of whom were treated with Cotrel-Dubousset instrumentation alone. Fourteen patients had Type III scoliosis. All were treated with Cotrel-Dubousset instrumentation with correction of 65%. Decompensation occurred in 4 patients, all of whom were fused to or beyond the stable vertebra. Four patients had Type IV scoliosis; all were fused short of the stable vertebra with Cotrel-Dubousset instrumentation, resulting in correction of 52% and no decompensation. Five patients had Type V instrumentation; four were treated with Cotrel-Dubousset instrumentation and 1 with Zielke. There was no relationship between level of fusion and decompensation. Based on this study, the authors contend that the King classification is a valuable tool in the selection of type of instrumentation and fusion level.
authors.affiliation: Department of Orthopaedic Surgery, Columbia Presbyterian Medical Center, New York, New York.
authors.forename: D P
authors.initials: DP
authors.lastname: Roye
authors.forename: J P
authors.initials: JP
authors.lastname: Farcy
authors.forename: J B
authors.initials: JB
authors.lastname: Rickert
authors.forename: D
authors.initials: D
authors.lastname: Godfried
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000145:classification / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000592:standards; D016896:Treatment Outcome