Long-Term Outcome of Surgical Treatment in Adolescent Idiopathic Scoliosis

With the development of the Harrington rod (Harrington, 1962) a long-segment rod and hook instrumentation was available for the first time, which became the worldwide standard procedure for many years in the surgical treatment of adolescent idiopathic scoliosis. According to a retrospective meta-analysis, Harrington rods were used in more than 85% of such cases between 1958 and 1993 (Haher et al., 1995). With this instrumentation, frontal correction was achieved primarily by the distraction and elongation of the concave side, and by the compression of the convex side of the curve. The disadvantage of this method was the flattening of the spinal profile (Humke et al., 1995), with less improvement of the rib hump deformity (Aaro & Dahlborn, 1982; Weatherley et al., 1987). Moreover, there have been reports of high revision rates with the complete removal of the instrumentation due to chronic complaints of the lumbar spine (Padua et al., 2001). The instrumentation has also required postoperatively external stabilisation for about 6 to 12 months with a plaster cast or an orthesis in order to avoid the loss of initial curve correction (Danielsson et al., 2001; Dickson & Harrington, 1973; Harrington, 1962; Mariconda et al., 2005).