There are many various possibilities of treatment from observation and conservative treatment, over simple bony fusion to exacting hemivertebrectomies and deformity correction. Retrospective analysis of various conservative and surgical techniques. Subjects. The total number of 702 patients treated in our department since 1976 had been evaluated. An average follow up is 17 years. Correction grade, security and efficiency of treatment methods, clinical results and complication rate were the main observed outcome measures. Group A (conservative treatment) - 356 pts. Group B (hemiepiphyseodesis) – 112 pts. Final result of correction was 9,8 degrees (22%). Group C (posterior instrumentated fusion) – 147 pts. Final result of correction was 25,6° (38%). Group D1 (anterior strut graft with posterior instrumentated fusion) – 27 pts. Final result of correction was 26° (40%). Group D2 (anterior osteotomy with posterior instrumentated fusion) – 33 pts. Final result of correction was 28° (43%). Group D3 (combined hemivertebrectomy with posterior instrumentated fusion) – 22 pts. Final result of correction was 31,3° (61%). Group D4 (posterior only hemivertebrectomy with instrumentated fusion) – 5 pts. Final result of correction was 30,7° (61%). Early detection, good timing and choosing of adequate surgical type are the main factors of quality treatment results. The best surgical method for formation failure types seems combined or posterior only instrumentated hemivertebrectomy and early hemiepiphyseodesis for segmentation failure types.
group A: conservative treatment – 321 pts. (49%) – the magnitude of the curves was at time of detection on average 35,7 degrees according to Cobb angle and 39,8 at time of last control with FU 13,7 year. group B: hemiepiphyseodesis – 102 pts. (16%) – the time of surgery was 6,6 years, follow up was 14,2 years. The magnitude of the curves was at time of detection on average 44,1 degrees, 44,2 preoperatively, 34,4 postoperatively and 38,4 at time of last control. Final result of correction was 9,8 degrees (22%). group C: posterior instrumentated fusion – 145 pts. (22%) – the time of surgery was 8,6 years, follow up was 18,9 years. The magnitude of the curves was at time of detection on average 59,2 degrees, 65,5 preoperatively, 39,9 postoperatively. Final result of correction was 25,6° (38%). group D1: strut graft with posterior instrumentated fusion – 27 pts. – the time of surgery was 11,8 years, follow up was 19,5 years. The magnitude of the curves was at time of detection on average 54,4 degrees, 65,6 preoperatively, 38,6 postoperatively. Final result of correction was 26° (40%). group D2: anterior osteotomy with posterior instrumentated fusion – 33 pts. – the time of surgery was 9,9 years, follow up was 18,3 years. The magnitude of the curves was at time of detection on average 58,1 degrees, 65 preoperatively, 37 postoperatively. Final result of correction was 28° (43%). group D3: combined hemivertebrectomy with posterior instrumentated fusion – 22 pts. – the time of surgery was 10,2 years, follow up was 12,1 years. The magnitude of the curves was at time of detection on average 46,4 degrees, 51,3 preoperatively, 20,3 postoperatively. Final result of correction was 31,3° (61%).
