Treatment of Scoliosis by Hartshill Rectangle and Sublaminar Wiring
Background: Scoliosis is a complex three dimensional deformity characterized by coronal, sagittal and horizontal plane deviation. Treatment of scoliosis has made significant development in techniques and modalities of internal fixation. Objective: To see the efficacy of Hartshill rectangle and sublaminar wiring for correction of scoliotic deformity, clinical outcome and patients satisfaction. Methods: During the period of July 2008 to June 2011, 14 patients of scoliotic spinal deformities of various etiologies (Congenital-02, idiopathic-12) were operated. Age ranged from 11 to 23 years with mean 16.71 ± 03.22 years. Female 09 and male 05 patients were included where Hartshill rectangles with sublaminar wiring were used for every case. Results: At least 12 months (range 12-36 months) follow up regarding clinico-radiological evaluation and patients satisfaction were accounted as per the SRS-24 questionnaire. The mean scoliosis in the coronal plane (Cobbs angle) measured 53.50o ± 03.98o preoperatively reducing significantly to 21.14o ± 02.77o (p<0.05) and the mean preoperative sagittal plane angle 60.14o ± 07.30o reducing significantly to average 42.14o ± 05.28o (p<0.05) at 1 year as determined by paired t-test. No neurological complication was seen except transient hyperesthesia in 02 patients, superficial wound infection in 01 patient and 01 wire breakage. All the patients were happy to live with their present back status. Conclusion: Overall outcome in segmental spinal fixation with sublaminar wire and Hartshill rectangle is satisfactory and effective.
BSMMU J 2012; 5(1):6-11