Treatment of Idiopathic Scoliosis by Harrington Instrumentation and Fusion with Fresh Autogenous Iliac Bone Grafts

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Abstract
Harrington instrumentation has proved to be a helpful adjunct in the over-all treatment of idiopathic scoliosis. This adjunct serves as either a major or a supplementary device for correction of the curve and as temporary internal fixation. A spine fusion maintains correction of a curve only if the fusion mass is of proper length and of sufficient strength to withstand the stresses imposed when the erect posture is resumed and all external immobilization is discontinued. A meticulously performed spine fusion to which a large amount of fresh autogenous cancellous bone has been added creates a favorable environment for the prompt formation, organization, incorporation, and remodeling of a massive bone graft into a strong fusion mass. The low pseudarthrosis rate and the maintenance of a high percentage of the initial correction in this series of eighty patients with ninety idiopathic curves appears to be due to three factors: the meticulous fusion technique supplemented with Harrington instrumentation, the use of large amounts of supplementary fresh autogenous iliac bone grafts, and adequate external immobilization.

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