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Post-Poliomyelitis Paralytic Scoliosis A Review of Curve Patterns and Results of Surgical Treatments in 118 Consecutive Patients

MAYER, PHILIP J., MD*; DOVE, JOHN, FRCS; DITMANSON, MARCY, MD; SHEN, YOUNG-SHUNG, MD

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Curve patterns and surgical treatment in 118 consecutive patients with post-poliomyelitic paralytic scoliosis are reviewed. The typical curve pattern was double structural curves, usually including the lumbar spine. Modifying the incision and altering the sequence of instrumentation facilitated both the exposure and instrumentation of the fourth and fifth lumbar bodies. Anterior fusion and Dwyer's instrumentation yield most of the correction of pelvic obliquity and significant correction of both the upper and lower curves. Two weeks of halofemoral traction did not achieve significant curve correction. It is suggested that staged anterior and posterior procedures result in structural correction of pelvic obliquity and paralytic scoliosis in severe deformities equal to the degree of correction obtained using posterior fusion and instrumentation alone in less severe cases.

*Department of Orthopaedics, H.S.C., S.U.N.Y. Stony Brook, Stony Brook, New York,

Hartshill Orthopaedic Hospital, Hartshill Road, Stoke-on-Trent, England

The Taiwan Scoliosis Fund, Taiwan, Republic of China.

© Lippincott-Raven Publishers.