Idiopathic scoliosis in a Jamaican population - abstract

ABSTRACT

This two-year retrospective study analyses the results of operative treatment of patients with idiopathic scoliosis, using the Harrington Instrumentation. The series consists of 63 consecutive cases, 50 boys and 13 girls. The average age at presentation was 16 years and the curves varied from 42§ to 86§. Most of the curves affected the dorso-lumbar vertebrae and the majority were convex to the right; 10 percent of the cases showed clinical evidence of neurofibromatosis and 15 percent had a marfanoid appearance with no systemic evidence of Marfan's syndrome. Seven cases were treated pre-operatively with a Risser's turnbuckle cast. Operative treatment consisted of correction of the major cure with a Harrington distraction rod and posterior fusion. On-lay bone graft was done using bone obtained from the spinous processes of the vertebrae. No additional bone was used. Post-operatively, all patients were nursed free on a Stryker frame for fourteen days. After this, an underarm plater jacket was applied. This was worn for three months. Patients were discharged after the jacket was applied and were allowed to attend school. Only restricted activities were allowed then. Full activities were allowed after the jacket was removed. The average correction obtained was 33 percent and the mean loss of correction after one year was 4§. The complications were varied and consisted of minor wound sepsis, temporary neurological deficit in two cases, intestinal obstruction in one case and pseudo-arthrosis in one cases. The scoliosis programme in Jamaica has contributed significantly to the improvement in the quality of life of affected patients. The emphasis now is on early detection and institution of early conservative management (AU)