The roentgenographic changes in the axial skeleton after irradiation for
Wilms' tumor were studied in eighty-one patients. In addition to the
initial alterations found in the individual vertebrae within the field of
irradiation, spinal deformity subsequently developed in fifty-nine patients
(pure scoliosis in thirty-eight, kyphoscoliosis in nineteen, and pure
kyphosis in two). Unitl the adolescent growth spurt these deformities
tended to remain slight, but some progression did occur. In seven patients
the scoliosis became severe enough to require spine fusion. A Milwaukee
brace used in three patients failed to correct the curve. The trapezoidal
shape of the vertebrae and scarring of the soft tissues within the
concavity made correction difficult. Recognizable roentgenographic
alterations failed to develop in twenty-two patients who, in general, were
older and had received less irradiation. There appeared to be a correlation
between the amount of irradiation and the severity of the spinal deformity
(p is less than 0.05) and between the age of irradiation and the amount of
deformity (p is less than 0.02).