Copyright & License
Copyright © 1941 by The Journal of Bone and Joint Surgery, Incorporated.
Authors
Author
A. R. SHANDS, JR.
Author
JOSEPH S. BARR
Author
PAUL C. COLONNA
Author
LAWRENCE NOALL
END-RESULT STUDY OF THE TREATMENT OF IDIOPATHIC SCOLIOSIS
Report of the Research Committee of The American Orthopaedic Association
Abstract
Four hundred and twenty-five cases of idiopathic scoliosis have been reviewed from an end-result standpoint. Cosmetic deformity is the chief complaint, the patients generally having no other symptoms. It is a disease appearing most frequently at the time of puberty, and predominating in girls about four to one. Curvature is to the right in 80 per cent. of the patients, most commonly in the mid-thoracic region.
All types of treatment were encountered in the series including observation only, symmetrical and asymmetrical exercises, supports, correction, and fusion, and combinations of all types. Fifty per cent. (214) of the patients reviewed had fusions done either immediately or after conservative treatment had been abandoned in favor of surgery. Correction was by means of the turnbuckle jacket in 80 per cent. of those corrected and fused. The average percentage of correction obtained was 65 and the average percentage of correction at end result was 27. Complete correction was gained in only 5.5 per cent. of the corrected cases, all of the correction was maintained in 8 per cent., and there was complete loss of correction in 29 per cent.
Additional bone grafts were used in 60 per cent. of the patients operated upon, and the incidence of pseudarthrosis for the entire operative group amounted to 28 per cent. Recumbency following fusion for three months was carried out with 47 per cent. of the patients.
The results in 69 per cent. of the cases at end result were rated fair or poor, and 31 per cent. good or excellent.