Idiopathic Scoliosis Treated with Harrington Instrumentation - A Long-Term Follow-Up

D. Grob, M.D.,
M. Rasmus, M.D.,
Thomas Egloff, M.D.
Schulthess Klinik,
Zürich, Switzerland

Treatment of idiopathic scoliosis with the technique of Harrington has been described almost half a century ago, however the information about long–term follow–up of this technique is sparse in literature. This retrospective follow–up study analyzes surgical outcome with a minimum follow–up of 20 years.

PATIENTS AND METHODS:
Out of 69 patients operated between 1968 and 1977, 56 (81.2%) were available for follow– up. There were 49 female and 7 male with an average age of 16 years (9–33) at the time of surgery. Outcome and function were analyzed in 56 patients, x–ray interpretation was performed in 46 patients. The average follow–up was 24.9 (20–30) years.

RESULTS:
92.9% of the patients are active in professional life or household. 7.1% are limited in their professional life. 5.4% are inactive due to problems of their spine. 82.1% are actively engaged in sports activities of which 14.3% are limited by their operated spine. The cosmetic appearance was rated in 87.7% as satisfactory, 10.7% were not satisfied with their physical appearance. 91% rated the surgical result as “good”, 71.4% would do the same operation again. 26.8% had significant pain (4–5 after Moskowitz). The average correction of the scoliotic deformity in the frontal plain was 50.6%. There was an average loss of correction of 17.4%. Statistical analyses of the results revealed a significant correlation between advanced degenerative changes of the non–fused lumbar spine with pain. Patients with marked degeneration of the lumbar spine belonged to the older age group and had more severe deformities preoperatively.

CONCLUSION:
The operative technique according to Harrington provides satisfactory results in idiopathic scoliosis after 20–30 year follow–up. The future will prove if more sophisticated surgical techniques are able to provide better results.