International Orthopaedics

, Volume 29, Issue 1, pp 47–50

Low back pain after spinal fusion and Harrington instrumentation for idiopathic scoliosis

  • Thomas Niemeyer
  • Albert Schulze Bövingloh
  • Sarah Grieb
  • Jürgen Schaefer
  • Henry Halm
  • Torsten Kluba
Original Paper

Abstract

We reviewed 41 patients with adolescent idiopathic scoliosis treated with spinal fusion and Harrington instrumentation between 1973 and 1992. The mean follow-up was 23 (11–30) years. All patients completed self-administered questionnaires, Oswestry Low Back Pain Disability Score (ODS), Roland Morris score (RLS), and Visual Analog Pain Intensity Scale (VAS). We found a high degree of satisfaction with more than three quarters of the patients in work. The outcome of ODS, RLS, and VAS showed low scores. We found a significant correlation between the scores and the Cobb angle preoperatively as well as at follow-up. The patient-oriented outcome did not correlate with the type of curve, extension of vertebral fusion, tilt angle of the lowest instrumented vertebra, postoperative Cobb angle, loss of correction, or lumbar lordosis. This long-term follow-up of Harrington rod fusion for adolescent idiopathic scoliosis showed no important impairment of health-related quality of life.

Résumé

Nous avons examiné 41 patients avec une scoliose idiopathique de l’adolescence traitée par fusion vertébrale et instrumentation de Harrington entre 1973 et 1992. La moyenne de suivi était de 23 ans (11–30). Tous les malades ont complété des questionnaires auto-administrés (Oswestry Score, Roland Morris Score et la cotation visuelle moyenne pour la douleur). Nous avons trouvé un haut degré de satisfaction avec plus de 3/4 des malades exerçant un travail. Les résultats des questionnaires ont montré des scores faibles. Nous avons trouvé une corrélation significative entre les scores et les angles de Cobb préopératoire aussi bien que postopératoire. Le résultat n’est pas en relation avec le type de courbe, l’extension de la fusion vertébrale, l’angle d’inclinaison de la plus basse vertèbre instrumentée, l’angle de Cobb postopératoire, la perte de correction ou la lordose lombaire. Ce suivi à long terme de la fusion rachidienne selon Harrington pour scoliose idiopathique de l’adolescent n’a montré aucune diminution importante de la qualité de vie des patients.

References

  1. 1.
    Asher M, Lai SM, Burton D, Manna B (2004) The influence of spine and trunk deformity on preoperative idiopathic scoliosis patients’ health-related quality of life questionnaire responses. Spine 29:861–868CrossRefPubMedGoogle Scholar
  2. 2.
    Cochran T, Irstam L, Nachemson A (1983) Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion. Spine 6:576–584Google Scholar
  3. 3.
    Danielsson AJ, Wiklund I, Pehrsson K, Nachemson AL (2001) Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up at least 20 years after treatment with brace or surgery. Eur Spine J 10:278–288CrossRefPubMedGoogle Scholar
  4. 4.
    Danielsson AJ, Cederlund CG, Ekholm S, Nachemson AL (2001) The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis. Acta Radiol 42:187–197PubMedGoogle Scholar
  5. 5.
    Dickson JH, Erwin WD, Rossi D (1990) Harrington instrumentation and arthrodesis for idiopathic scoliosis. A twenty-one-year follow-up. J Bone Joint Surg Am 72:678–683PubMedGoogle Scholar
  6. 6.
    Freidel K, Petermann F, Reichel D, Steiner A, Warschburger P, Weiss HR (2002) A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome. Spine 20:2002–2004 (discussion p 2005)Google Scholar
  7. 7.
    Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J (2002) Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrumentation and their relevance for expert evidence. Z Orthop Ihre Grenzgeb 140:492–498CrossRefPubMedGoogle Scholar
  8. 8.
    Gotze C, Liljenqvist UR, Slomka A, Gotze HG, Steinbeck J (2002) Quality of life and back pain: outcome 16.7 years after Harrington instrumentation. Spine 27:1456–1463CrossRefPubMedGoogle Scholar
  9. 9.
    Helenius I, Remes V, Yrjonen T, Ylikoski M, Schlenzka D, Helenius M, Poussa M (2002) Comparison of long-term functional and radiologic outcomes after Harrington instrumentation and spondylodesis in adolescent idiopathic scoliosis: a review of 78 patients. Spine 27:176–180CrossRefPubMedGoogle Scholar
  10. 10.
    Humke T, Grob D, Scheier H, Siegrist H (1995) Cotrel-Dubousset and Harrington instrumentation in idiopathic scoliosis: a comparison of long-term results. Eur Spine J 4:280–283CrossRefPubMedGoogle Scholar
  11. 11.
    Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343CrossRefPubMedGoogle Scholar
  12. 12.
    Opitz G, Zielke K (1990) 10-Year results following surgery of idiopathic scoliosis using the Harrington technique (work by the Conference of German-language Spinal Surgeons). Orthop Ihre Grenzgeb 128:482–489Google Scholar
  13. 13.
    Padua R, Padua S, Aulisa L, Ceccarelli E, Padua L, Romanini E, Zanoli G, Campi A (2001) Patient outcomes after Harrington instrumentation for idiopathic scoliosis: a 15- to 28-year evaluation. Spine 26:1268–1273CrossRefPubMedGoogle Scholar
  14. 14.
    Poitras B, Mayo NE, Goldberg MS, Scott S, Hanley J (1994) The ste-justine adolescent idiopathic scoliosis cohort study. Part IV. Surgical correction and back pain. Spine 19:1582–1588PubMedGoogle Scholar
  15. 15.
    Pratt RK, Burwell RG, Cole AA, Webb JK (2002) Patient and parental perception of adolescent idiopathic scoliosis before and after surgery in comparison with surface and radiographic measurements. Spine 27:1543–1550 (discussion p 1551–1552)CrossRefPubMedGoogle Scholar
  16. 16.
    Wiesinger GF, Nuhr M, Quittan M, Ebenbichler G, Wolfl G, Fialka-Moser V (1999) J cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain. Spine 24:1099–1103CrossRefPubMedGoogle Scholar
  17. 17.
    Willers U, Hedlund R, Aaro S, Normelli H, Westman L (1993) Long term results of Harrington instrumentation in idiopathic scoliosis. Spine 18:713–717PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Thomas Niemeyer
    • 1
  • Albert Schulze Bövingloh
    • 1
  • Sarah Grieb
    • 1
  • Jürgen Schaefer
    • 2
  • Henry Halm
    • 3
  • Torsten Kluba
    • 1
  1. 1.Spine Service, Department of Orthopedic SurgeryUniversity Hospital TübingenTubingenGermany
  2. 2.Department of RadiologyUniversity Hospital TübingenTubingenGermany
  3. 3.Centre for Spinal Surgery and ScoliosisKlinikum NeustadtNeustadtGermany

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