Of sixty-four patients with Marfan's syndrome, thirty-five had
scoliosis, which in 44 per cent began in the infantile and juvenile age
periods. The curve patterns were double major right thoracic-left lumbar in
48 per cent and single right thoracic in 33 per cent. At the start of
treatment the curves were severe (average, 72 degrees) and quite structural
(average bending correction, 36 per cent). Seventy-four per cent of the
thirty-five patients had back pain. Inadequately treated and untreated
curves usually progressed to severe and painful deformity. Milwaukee brace
treatment was generally unsuccessful because of the severity and rigidity
of the curves or the poor maintenance of correction obtained. Spine fusion
combined with Harrington rod instrumentation (fourteen patients) gave an
average correction of 41 per cent with an average loss of 7 degrees
(average follow-up, 2.3 years). Operative treatment of scoliosis is
indicated in most patients with Marfan's syndrome.