[An approach to correcting scoliosis. Mechanism and operative procedure]

Abstract

In the treatment of scoliosis, we found that soft tissue contracture on the concave side is the main force maintaining deformity, resisting correction and rejecting implants. So the release of contracture would get rid of the bow-string effect of the contractured tissues from the main curve, such as the capsules and ligaments around costo-transverse joints, the inter-transverse and intercostal muscles, together with the posterior section of the corresponding ribs would also be taken off by those shrunken tissues close to the main curve, like the capsules and ligaments around the costo-vertebral joints. Since 1982, 23 patients aged 6 to 16 years were treated operatively. The operation was done in 2 stages: contracture release on the concave side and fusion with bone grafting on both side laminae through body cast. Follow up for 1 to 8.5 years showed satisfactory results. The mechanism and effect of soft tissue contracture of idiopathic and congenital scoliosis are discussed in detail.