Hardware complications in scoliosis surgery.
BACKGROUND
Scoliosis surgery has undergone a dramatic evolution over the past 20 years with the advent of new surgical techniques and sophisticated instrumentation. Surgeons have realized scoliosis is a complex multiplanar deformity that requires thorough knowledge of spinal anatomy and pathophysiology in order to manage patients afflicted by it. Nonoperative modalities such as bracing and casting still play roles in the treatment of scoliosis; however, it is the operative treatment that has revolutionized the treatment of this deformity that affects millions worldwide. As part of the evolution of scoliosis surgery, newer implants have resulted in improved outcomes with respect to deformity correction, reliability of fixation, and paucity of complications. Each technique and implant has its own set of unique complications, and the surgeon must appreciate these when planning surgery.


METHODS
Various surgical techniques and types of instrumentation typically used in scoliosis surgery are briefly discussed. Though scoliosis surgery is associated with a wide variety of complications, only those that directly involve the hardware are discussed. The current literature is reviewed and several illustrative cases of patients treated for scoliosis at the Connecticut Children's Medical Center and the Newington Children's Hospital in Connecticut are briefly presented.


CONCLUSIONS
Spine surgeons and radiologists should be familiar with the different types of instrumentation in the treatment of scoliosis. Furthermore, they should recognize the clinical and roentgenographic signs of hardware failure as part of prompt and effective treatment of such complications.
Bagchi
Kaushik
K
Present address: 5302 Bishop's View Circle, Cherry Hill, NJ 08002, USA. kaushik_bagchi@hotmail.com
Mohaideen
Ahamed
A
Thomson
Jeffrey D
JD
Foley
L Christopher
LC
D000293:Adolescent; D000328:Adult; D001858:Bone Nails / Q000009:adverse effects; D001863:Bone Screws / Q000009:adverse effects; D001864:Bone Wires / Q000009:adverse effects; D002648:Child; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D013502:General Surgery / Q000295:instrumentation*; D006801:Humans; D008297:Male; D009141:Musculoskeletal System / Q000000981:diagnostic imaging / Q000601:surgery; D009985:Orthopedics / Q000379:methods / Q000592:standards; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*