Surgical treatment of neuropathic scoliosis: morphologic and functional outcome

Abstract

We evaluated the morphologic and functional outcome as well as the extent of satisfaction following surgical treatment in 41 patients with progressive neuropathic scoliosis. The mean follow-up time was 5.6 years (range 2.5–20 years), and follow-up rate was 97.6%. Posterior spine fusion was performed with new instrumentation techniques (Luque/Luque-Galveston, CD, ISOLA) in 29 patients, with extension onto the sacrum in 16 patients, and Harrington instrumentation in 12. In 20 patients we did an additional intervertebral disc excision and fusion. Mean correction of the thoracic spine deformity, as assessed by comparing the Cobb angles on pre- and postoperative X-rays, was 53%, and of the lumbar spine 55.2%, in patients classified as Lonstein I. Scolioses classified as Lonstein II evidenced an average correction of 46.2%. Functional improvement according to the Rancho-Los Amigos scheme could be demonstrated in 20 patients. Seventeen patients remained unchanged, whereas 4 patients showed deterioration. Cosmetic results were rated as excellent by 25 patients, good by 7, and poor by 1. For 8 patients the appearance was unimportant. Pain relief was experienced in all cases (n = 4) of the preoperative low-back or abdominal pain. The major complications were deep wound infection in 3 patients which led to revision surgery, and removal of instrumentation in I patient.