Aggressive surgical treatment of secondary spinal deformity in spina bifida children--is it worthwhile?

The results of sixty-five surgical corrections of secondary spinal deformities in spina bifida children are reported. Twenty-three patients had kyphectomies, and thirty-nine patients had anterior and posterior spinal fusions for scoliosis. There were three deaths. Patients in both groups showed functional improvement, though the effects on respiratory function were minimal. Patients with scoliosis should have their surgery before the curve reaches 100 degrees. Correction in these patients may have to be carried out very early if there is rapid curve progression. Kyphectomy ideally should be carried out between the ages of ten and fourteen years when bone size and quality are suitable for fixation.