TREATMENT OF PATIENTS WITH GRADE III–IV THORACOLUMBAR SCOLIOSIS AFTER PRIOR SURGERY BY HARRINGTON METHOD

Abstract

Objective. To analyze the results of idiopathic scoliosis correction with instrumentation developed by the authors in patients previously operated by the Harrington method. Material and Methods. Ten patients of 14–31 years of age with grade III–IV scoliotic deformity previously operated by the Harrington method were reoperated with universal endocorrector. The reasons for repeat surgery included a fracture of Harrington rod, insufficient correction of scoliotic deformity, perforation of the vertebral arch by distractor hook, and the trunk imbalance. All patients underwent simultaneous two-stage surgery involving distractor removal and scoliosis correction with universal endocorrector. The follow-up period was 6–24 months. Results. Mean correction in rod fracture group was 61.08 % without complications, in undercorrection group (mean correction 27.24 %) it achieved 63.39 %. In the group of patients with vertebra arch penetration and pain syndrome the mean correction by universal endocorrector was 34.29 % with 100 % reduction of pain. During the 6–24 months follow- up there were no correction loss or neurologic and septic complications in operated patients. Conclusions. The new instrumentation provides greater correction (1.8 times) of scoliotic deformity than Harrington rod instrumentation. It is successfully used in repeat surgery and equally effective both in adolescent and in adult scoliosis.