The operative treatment of congenital scoliosis. A report of 23 patients.

Spinal fusion was performed in 23 patients with congenital scoliosis. Various procedures were used including posterior fusion and without instrumentation. No surgical procedure proved to be superior for obtaining correction regardless of the use of supplemental instrumentation. The use of Knodt or Harrington Instrumentation could not be correlated with a lower pseudoarthrosis rate, shorter postoperative immunobilization period, or a decrease in postoperative loss of correction. The morbidity associated with these surgical procedures was high (48%). Thoracic curves were more prone to lengthen or develop kyphoses postoperatively. A high incidence of varied congenital anomalies was found in association with congenital scoliosis. A through work-up including an intravenous pyelogram and myelogram is strongly recommended prior to the operative treatment of congenital scoliosis.