Surgical treatment of scoliosis using Harrington instrumentation and arthrodesis. A comparison of 2 series with and without sublaminar segmental wiring

Abstract

The use of sublaminar segmental wires to enhance the stability of Harrington instrumentation was assessed in a review of our experience in the treatment of scoliosis over the last 6 years. Thirty patients were treated by spinal fusion, Harrington instrumentation and a prolonged postoperative period of immobilisation, initially in a plaster cast and then in a brace (Group 1). A further 29 patients have been treated by augmenting the Harrington instrumentation with sublaminar segmental wires (Group 2). Post-operatively, this group was left free of any brace or cast and early mobilisation was allowed. We observed no neurological complication in either group. The blood loss and the duration of the operation were greater in Group 2, but the period of hospitalisation and time to return to school has been markedly reduced. There has been no significant difference in the degree of correction of the scoliosis between the groups, but the improvement in kyphosis was greater with the use of sublaminar wires. There were no pseudoarthroses in either group during a minimum follow up of 18 months.