Scoliosis in arthrogryposis multiplex congenita: Results after nonsurgicaland surgical treatment

Forty-six patients (25 male and 21 female) with arthrogryposis multiplex co ngenita who were seen at the Alfred I. duPont Hospital for Children between the years 1940 and 1997 were evaluated to assess the prevalence and patter ns of scoliosis and the long-term results after both nonsurgical and surgic al treatment methods. We found the prevalence of scoliosis to be 65.9% (32 of 46 patients). A single thoracolumbar curve was the predominant curve pat tern. No congenital curve types or vertebral anomalies were seen in our gro up of patients. In the nonsurgical group, the mean curve was <30 degrees at followup. In the surgical group, the mean primary curve before spinal arth rodesis was 78.5 degrees. Three patients in the surgical group who were non ambulators have become household ambulators at the most recent follow-up. W e recommend bracing in patients who are ambulators and have a curve of <30 degrees. Combined anterior and posterior spinal arthrodesis gave the best r esults.