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Long-term results of Harrington instrumentation in idiopathic scoliosis
1Department of Orthopaedic Surgery, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Insights
Harrington instrumentation improved the Cobb angle in idiopathic scoliosis patients long-term. However, it did not correct rotational or sagittal deformities, with apical vertebral rotation significantly increasing.
Area of Science:
- Orthopedics
- Spinal Surgery
- Radiology
Background:
- Idiopathic scoliosis is a complex spinal deformity.
- Harrington instrumentation was a common surgical treatment for scoliosis.
- Long-term outcomes of Harrington instrumentation require further investigation.
Purpose of the Study:
- To evaluate the long-term efficacy of Harrington instrumentation in treating idiopathic scoliosis.
- To assess the impact of Harrington instrumentation on coronal, rotational, and sagittal spinal parameters.
Main Methods:
- A retrospective study of 33 patients with idiopathic scoliosis.
- Preoperative, postoperative, and long-term follow-up (mean 10.8 years) assessments.
- Utilized posteroanterior radiographs and computed tomography (CT) for measurements.
Main Results:
- Significant improvement in the mean Cobb angle (40%) at long-term follow-up.
- No significant changes in rib hump, apical vertebral translation, or sagittal thoracic diameter.
- Apical vertebral rotation significantly increased over the long term.
- Mean thoracic kyphosis was 17.3 degrees and lumbar lordosis was 22.0 degrees at follow-up.
Conclusions:
- Harrington instrumentation effectively improves the coronal Cobb angle in idiopathic scoliosis long-term.
- The instrumentation does not correct rotational deformities, which may worsen.
- Sagittal plane parameters and trunk deformity (rib hump) remain largely uncorrected.
Abstract:
The long-term effect of Harrington instrumentation was investigated using posteroanterior radiographs and computed tomographic measurements preoperatively, postoperatively, and at a mean follow-up at 10.8 years in 33 patients with idiopathic scoliosis. No patient was lost from long-term follow-up. At follow-up, the mean Cobb angle was improved by 23.7 (40%) compared with the preoperative findings. The rotation of the apical vertebra was increased significantly. The rib hump, the translation of the apical vertebra, and the sagittal diameter of the thoracic cage were unchanged. At follow-up, the mean thoracic kyphosis was 17.3, and lumbar lordosis was 22.0. This study demonstrated that the long-term effect of Harrington instrumentation was limited to an improved Cobb angle; no correction of the rotational or sagittal deformities were achieved.