We reviewed the cases of 110 patients with paralytic scoliosis due to
poliomyelitis who were operated on. In the lumbar region, anterior Dwyer
instrumentation with posterior fusion gave excellent correction of
scoliosis and pelvic obliquity. In the more rigid thoracic curves, combined
anterior Dwyer instrumentation and posterior fusion gave better results
than posterior fusion alone, but had more morbidity. Long c-shaped curves
benefited more from a combined anterior Dwyer procedure at the apex of the
curve and long posterior Harrington instrumentation. Traction was found to
be of use only in rigid curves and in those larger than 80 degrees. With
combined anterior and posterior fusion, there was a pseudarthrosis rate of
7 per cent in lumbar curves, none in thoracic curves, and 12.5 per cent in
long c-shaped curves. The pseudarthrosis rate rose to more than 25 per cent
in patients who had a posterior fusion alone.