Preservation of lumbar lordosis in surgical treatment of thoracolumbar scoliosis using a modified Harrington instrumentation: Case studies

Four adolescent thoracolumbar scoliotic patients, 3 idiopathic and one neurofibromatosis, were surgically treated with posterior spinal fusion and instrumentation using a contoured square-ended distraction Harrington rod, supplemented with segmental sublaminar wiring and an interspinous process wiring between the distal 2 vertebrae. Their average age was 13.8 years. Before operation, the average curve magnitude was 75°(range, 55°-102°) and the average lumbar lordosis was 50°(range, 39°-62°). The lower instrumented vertebra was L4 in 3 cases and LS in one case. The follow-up period ranged from 10 months to 18 months (average, 14 months). At final follow-up, the average curve correction was 41% (range 27%- 60%) and the average lumbar lordosis was 52°(range, 44°-67°). The lumbar lordosis was well preserved and the patients were satisfied with their results.