SURGICAL-TREATMENT OF NEUROPATHIC SCOLIOSIS - MORPHOLOGIC AND FUNCTIONAL OUTCOME

We evaluated the morphologic and functional outcome as well as the ext ent of satisfaction following surgical treatment in 41 patients with p rogressive neuropathic scoliosis. The mean follow-up time was 5.6 year s (range 2.5-20 years), and follow-up rate was 97.6%. Posterior spine fusion was performed with new instrumentation techniques (Luque/Luque- Galveston, CD, ISOLA) in 29 patients, with extension onto the sacrum i n 16 patients, and Harrington instrumentation in 12. In 20 patients we did an additional intervertebral disc excision and fusion. Mean corre ction of the thoracic spine deformity, as assessed by comparing the Co bb angles on pre- and postoperative X-rays, was 53%, and of the lumbar spine 55.2%, in patients classified as Lonstein I. Scolioses classifi ed as Lonstein II evidenced an average correction of 46.2%. Functional improvement according to the Rancho-Los Amigos scheme could be demons trated in 20 patients. Seventeen patients remained unchanged, whereas 4 patients showed deterioration. Cosmetic results were rated as excell ent by 25 patients, good by 7, and poor by 1. For 8 patients the appea rance was unimportant. Pain relief was experienced in all cases (n = 4 ) of the preoperative low-back or abdominal pain. The major complicati ons were deep wound infection in 3 patients which led to revision surg ery, and removal of instrumentation in 1 patient.