J Korean Orthop Assoc.  1977 Sep;12(3):309-333. 10.4055/jkoa.1977.12.3.309.

The clinical Study of Scoliosis

Abstract

A total of 132 cases of structural scoliosis have been followed since Jan. 1963 up to Dec. 1976 at the Hanyang University Hospital. The present paper classified scoliosis according to the etiology and analyzed curve patterns and spinal deformties such as rotation and wedging. Various kinds of treatment were done and these included Milwaukee brace, posterior spinal fusion with or without Harrington instrumentation. The end results of these treatment were also analyzed. The results concluded from the present studies were as follows: 1. Poliomyelitis was the most common cause of structural scoliosis. Of 132 cases of scoliosis, paralytic scoliosis was 48.5% while idiopathic scoliosis was 31.1% and congenital scoliosis 9.8%. 2. In paralytic scoliosis lumbar curves were the most common pattern and thoracic and thoracolumbar curves were the next. 3. In idiopathic scoliosis, the most common pattern was the right thoracic. 4. Very severe curves over 80° were more frequent in paralytic than in idiopathic scoliosis, showing the percentage of 20.3% in paralytic scoliosis and 10.3% in idiopathic scoliosis respectively. 5. The number of vertebrae involved in primary curve was approximately the same in both paralytic and idiopathic scoliosis. 6. In paralytic scoliosis, as the curves progressed, rotation of vertebrae became more marked in lumbar curve than in thoracic curve, while wedging deformity was more severe in thoracic curve than in Jumbar curve. 7. The tendency of the rotation and wedging in thoracic and lumbar curve was the same in both idiopathic scoliosis and paralytic scoliosis. When the degree of curves was the same, rotation and wedging were slightly more severe in idiopathic than in paralytic scoliosis. 8. In congenital scoliosis hemivertebrae were the most common anomaly and the majority of congenital anomalies were located at lumbar region. 9. Treated with Milwaukee brace, 22.1% of original curve angle was corrected in idiopathic coliosis, 9.8% in paralytic scoliosis, and 7.3% in congenital scoliosis, respectively. The Milwaukee brace was effective in thoracic and thoracolumbar curves but not in lumbar curves. 10. In paralytic scoliosis treated with posterior spinal fusion without Harrington instrumentation, the final degree was 43.2 and the correction loss was 12.6% but with both posterior fusion and Harrington instrumentation, the final degree was 50.2 and the correction loss was 6.8%. 11. There were 2 cases of complication after posterior spinal fusion without Harrington instrumentation. One was pseudarthrosis and the other was bending of graft with some loss of correction. One case of complication occured after posterior spinal fusion with Harrington instrumentation. It was a case of displacement of distraction hook on the rod.

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