Results of Spinal Instrumentation of Adolescent Idiopathic Scoliosis by King Type

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Abstract
The purpose of this study is to datermine the usefulness of the King classification in predicting decompensation in adolescent idiopathic scoliosis, Fifty-one patients were reviewed with a mean follow-up of 25 months. Five patients had Type 1 adolescent idiopathic scoiiosis: four were treated with Zielke/Cotrel-Dubousset Instrumentation or Zielke instrumentation alone. Correction was greater than 51% in these cases and there was no decompensation. Twenty-three patients had Type II scollosis. Nineteen of whom were treated with Cotrel-Dubousset instrumentation; 3 with Zielke and Cotrel-Dubousset instrumentation, and 1 with Zielke. The best correction occurred with anterior/posterior instrumentation. Decompensation occurred in 9 patients, all of whom were treated with Cotrel-Dubousset instrumentation atone. Fourtean patients had Type III scoliosis. All were treated with Cotrel-Dubousset instrumentation with correction of 65%. Decompensation occurred In 4 patients, all of whom were fused to or beyond the stable vertebra. Four patients had Type IV scoliosis; all were fused short of the stable vertebra with Cotrel-Dubousset instrumentation, resulting in correction of 52% and no decompensation. Five patients had Type V instrumentation; four were treated with Cotrel-Dubousset instrumentation and 1 with Zielke. There was no relationship between level of fusion and decompensation. Based on this study, the authors contend that the King classilication is a valuable tool in the selection of type of instrumentation and fusion level.

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