Original Article

THE EVALUATION OF THE RESULTS OF MIXED TYPE CONGENITAL SCOLIOSIS PATIENTS TREATED WITH POSTERIOR FUSION AND POSTERIOR INSTRUMENTATION

  • Alper KAYA
  • İ. Teoman BENLİ
  • Berk GÜÇLÜ

J Turk Spinal Surg 2008;19(3):173-183

Aim:

The aim of the study is to evaluate the results of posterior fusion and posterior instrumentation with translation in syndromic and mixed type congenital scoliosis patients.

Patients and Method:

21 scoliosis patients average age 12.8 ± 3.4 (8-15) years who have at least 2 years (average 44.1±14.1 months) follow-up period included the study. Clinical, radiological and magnetic resonance imaging evaluation were performed and patients classified according to Winter’s classification. All of the patients had mixed type deformity and 9 of them had syndromic type deformity. Deformities were corrected with posterior fusion and posterior instrumentation with translation in all of the patients. Patients were divided into groups according to the correction in their bending radiographies and ages; as correction was smaller than 20 % (rigid) and between 20 and 50 %, and patients were between 8 and 10 years old (preadolescent) and between 11 and 15 years old (adolescent). The frontal correction rated were compared in these groups and additionally clinical status and patients’satisfaction rates from treatment were determined with SRS-22 scores at last follow-ups.

Results:

There were 33 formation defect and 21 segmentation defect in 21 patients. There were 9 Klippel-Feil syndrome, 1 developmental hip dysplasia, 4 tarsal coalition, 1 multipl rib deformity, 2 vertical talus, 2 heart valve anomaly, 1 renal ectasia and 1 hydrocephaly associated in these patients. It was shown that there was average 25.5 ± 11.4% correction obtained in the patients that performed posterior instrumentation with translation. In moderate curves and preadolescent patients it was shown that the correction rates were higher (average 39.5 ± 8.1 %). It is identified that in all groups total score of SRS-22 was average 4.1 ± 1.1, and the satisfaction rates from treatment was 4 or more.

Conclusion:

According to the datas of this study, it is thought that satisfactory results can be obtained with posterior instrumentation with translation and posterior fusion, regardless of the rigidity of the curves in preadolescent mixt type congenital scoliosis patients that show rapid progression.

Keywords: Congenital scoliosis, mixed type congenital scoliosis, syndromic congenital scoliosis, posterior instrumentation, insitu fusion.