[Surgical treatment of infantile and juvenile scoliosis--a retrospective analysis of 21 patients].
OBJECTIVE
We carried out a retrospective analysis of 21 patients with infantile or juvenile scoliosis (9 boys, 12 girls) who underwent surgical treatment between 1985 and 1997. 13 patients underwent primary dorsal instrumentation without fusion (growing-rod group). In contrast, 8 patients received already in this young age an instrumented spondylodesis (fusion-group).


METHODS
The initial examination was performed at an age of 6 years (median; range 29 years), and first surgery was performed at an age of 8 years (median, range 310 years). The patients have been followed-up clinically and radiologically at an age of 16 years (median; range 1021 years).


RESULTS
The preoperative measurement showed no significant differences between both groups (thoracic Cobb angle 77 degrees versus 66 degrees [median], lumbar Cobb angle 40 degrees versus 51 degrees [median]). At follow-up we measured significantly better results in the fusion-group than in the growing-rod group (thoracic Cobb angle 24 degrees versus 60 degrees [median; p < 0.01]), lumbar Cobb angle 21 degrees versus 34 degrees [median, p < 0.05]). The fusion-group also showed significantly better results with respect to the parameters (median values given): duration of hospital stay (14 versus 150 days), number of operations per patient (2 versus 3) and number of complications (0 versus 26).


CONCLUSIONS
Based on the results of this small patient group we no longer see an indication to treat infantile and juvenile scoliosis by dorsal instrumentation without fusion. In contrast, we find the principle of short instrumented anterior fusion to be more promising.
Muschik
M
M
Seehospital Sahlenburg der Nordheim-Stiftung, Krankenhaus für Orthopädie, Wirbelsäulenchirurgie und Rheumatologie, Cuxhaven, Berlin, Germany. Muschik@Seehospital-Sahlenburg.de
Labs
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K
Zippel
H
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*