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COMBINED ANTERIOR AND POSTERIOR SURGERY FOR SCOLIOSIS THE USE OF THE HARTSHILL SYSTEM

  • N. W. Valentine
  • J. Dove

J Turk Spinal Surg 1990;1(1):4-5

From January 1984 to November 1988, 25 patients had combined anterior and posterior corrective surgery using the Hartshill Rectangle. There were 6 male and 19 female patients. The age range was 5 to 30 years (mean 13). In 17 cases the scoliosis was idiopathic, the others were due to spina bifida, hemivertebra, diastematomyelia and paraspinal tumour. 12 were done as a combined procedure, and 13 had a delayed second stage. Anterior surgery consisted of epiphyseodesis or growth arrest without internal fixaton in 18, and Dwyer's instrumentation in 7.

The average preoperative curve was 79 degrees (range 38-140), and the postoperative average was 35 degrees (5- 88). At latest follow up the residual curve averaged 41 degrees (5-107). Complications were few, with one superficial wound infection, one deep wound infection. In one case of spina bifida, the fixation of the rectangle on the sacrum was lost. Two cases had neurological complications, with complete recovery in one. The other was a complete lesion with little recovery at latest review.

Combined anterior and posterior surgery using the llartshill system is reliable and successful, with good correction of deformity and an acceptably low incidence of complications.

Keywords: Scoliosis, segmental fixation, anterior surgery, neurological complications.