From recent studies of postoperative end results in the treatment of scoliosis, we have found what we believe to be the causes for substandard clinical end results. We have revealed that excessive correction of single primary curves by the hinge-jacket technique has caused subsequent loss of balance. As a result of the excessive correction, these primary curves of the Spine have been forced to spontaneously re-establish their own body balance. We have presented the several courses taken by these cases in their postoperative Spontaneous return to balance, evidenced clinically in recurrent primary deviations, or in new deformities in adjacent areas of the spine.

In conclusion, many of the substandard results in the hinge-jacket treatment of scoliosis at the New York Orthopaedic Hospital have been traced to excessive correction in single primary curves. Further, the failure of compensatory curves to reverse spontaneously, in response to jacket correction of a single primary curve, is a consistent finding. Jacket corrections which do not take into consideration multiple spine deformity and total body balance are doomed to relative failure, either by compensatory phenomena, which develop secondarily, or by loss of primary correction.

Finally, more comprehensive principles of corrective therapy have done much to improve and to expedite surgical therapy. The transection jacket, after four years of use on more than 100 cases, has proved a highly valuable adjunct.