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Scoliosis surgery and its effect on back shape
R J Jefferson1, I Weisz, A R Turner-Smith
1Oxford Orthopaedic Engineering Centre, England.
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1988
Summary
Spinal surgery for adolescent idiopathic scoliosis improves lateral curvature but has limited impact on transverse plane deformity. Costoplasty offers significant cosmetic improvement for persistent severe scoliosis.
Area of Science:
- Orthopedics
- Spinal Surgery
- Medical Imaging
Background:
- Adolescent idiopathic scoliosis (AIS) presents a significant spinal deformity.
- Surgical correction aims to improve both spinal alignment and cosmetic appearance.
- Assessing the effectiveness of different surgical techniques on 3D spinal shape is crucial.
Purpose of the Study:
- To evaluate the effectiveness of spinal surgery and costoplasty in correcting spinal deformities in adolescent idiopathic scoliosis.
- To compare the impact of Harrington instrumentation and sublaminar wiring versus costoplasty on spinal shape and cosmetic outcomes.
Main Methods:
- Radiography and the integrated shape imaging system (ISIS) were used to assess 34 patients with AIS.
- Patients underwent either Harrington instrumentation (27 patients), sublaminar wiring (2 patients), or costoplasty (5 patients).
- Measurements were taken before and after surgical intervention.
Main Results:
- Harrington instrumentation significantly improved lateral spinal curvature but showed less pronounced changes in the transverse plane.
- Sublaminar wiring successfully corrected thoracic lordosis in two patients.
- Costoplasty led to significant improvements in back shape measurements for patients with severe, persistent deformities.
Conclusions:
- Spinal surgery alone only partially corrects the cosmetic deformity associated with scoliosis.
- Costoplasty directly addresses and improves the surface shape of the back, offering better cosmetic results for severe cases.