Three-dimensional correction of scoliosis using TSRH instrumentation.

OBJECTIVE

To evaluate the results of TSRH instrumentation in the correction of coronal, sagittal and rotational deformity of scoliosis.

METHODS

From January 1998 to December 1999, thirty-two consecutive patients (6 males, 26 females)with scoliosis underwent anterior or posterior spinal instrumentation and fusion using TSRH instrumentation. Of these cases, 21 were idiopathic scoliosis and 11 were congenital scoliosis. The average age at surgery was 16.4 years (range, 11 approximately 45 years). The mean Cobb angle at surgery was 71.2 degrees range, 44 degrees approximately 125 degrees) in the coronal plane, and 49. degrees range, 16 degrees aprroximately 67degrees in the sagittal plane. Rotational deformity (Nash-Moe) ranged from I to III degree. Preoperative apical translation averaged 4.8 cm (range, 3 approximately 9 cm).

RESULTS

The average follow-up duration was 13.3 months (range, 10 approximately 24 months). At the final follow-up, the mean Cobb angle in the coronal plane was 26.6 (range, 10 degrees approximately 73 degrees), with a 63.8% of improvement. Sagittal alignment was well maintained with a mean Cobb angle of 28 degrees (range, 10 degrees approximatelky 45 degrees). The average correction of rotation of the apical vertebra was I degree. The average apical translation was 1.6 cm (range, 0.5 approximately 5.0 cm) representing a correction rate of 66, 7%. Complication was noted in two cases with an incidence of 3.1%, one case had superficial infection and the other one had lower hook dislocation. There was no neurologic deficit and pseudoarthrodesis in this series.

CONCLUSION

TSRH instrumentation is an effective and convenient three-dimensional correction system with a lower rate of complication, which can not only correct the coronal and rotational deformity, but maintain the sagittal alignment as well.