Late results of Harrington's operation. Long-term evolution of the lumbar spine below the fused segments

Between 1963 and 1971, Harrington's technique was used by the senior author to operate on 493 scoliotic patients, of which 364 were idiopathic. A total of 276 patients were reexamined, of which 209 were idiopathic cases. All met the following criteria: a follow-up period of at least 10 years; the operation was performed by the same surgeon; and the review was undertaken by one person. The average follow-up period was 13 years, 10 months. A total of 95 patients had a follow-up period of more than 15 years, of these 75 patients were idiopathic. The surgical technique was similar in all cases: a distraction rod in the concavity, arthrodesis by decortication, and a corticospongious graft obtained from one or both iliac crests. Postoperative immobilization was assured by a plaster corset for 6 months, followed by a "plexidur corset lyonnais." The review of the patients examined was based on rigorous clinical and radiological analyses. Anteroposterior and lateral radiographs were obtained, complemented by a lateral radiograph of the lumbosacral segment. The angular results were disappointing, decreasing from 66.2 degrees to 38 degrees immediately postoperatively but increasing to an average final curve of 51.4 degrees. Clinical results were good: Only 21.3% of patients actually had back pain. The patients were satisfied with their appearance and their professional, social, and marital status. This study indicates the outcome of the lumbar spine below the graft. The vertebral bodies were modified morphologically; they became elongated and more trapezoidal leading to a quite normal average lordosis.(ABSTRACT TRUNCATED AT 250 WORDS)