Fusion to the sacrum for nonparalytic scoliosis in the adult.

This study is a retrospective review of 43 adult patients with idiopathic or congenital scoliosis who had spinal fusion from T11 or above to the sacrum. This study was prompted by the frustrations of the treating surgeons in attempting long fusions from the thoracic spine to the sacrum. Of 25 patients treated with a single-stage posterior fusion only 28% had a good result with a single procedure. Failures were due to pseudarthrosis, decompensation, or loss of lumbar lordosis. Ten patients treated with posterior fusion and subsequent 6-month augmentation had a 70% success rate. Eight patients treated with anterior followed by posterior fusion had a 75% success rate. The ideal answer to this clinical problem has not yet been found.