Fifty-eight adults who had scoliosis or hyperlordosis had anterior
arthrodesis and Zielke instrumentation. Postoperatively, the curve improved
68 per cent in forty-nine patients who had idiopathic scoliosis and 40 per
cent in nine patients who had paralytic scoliosis or hyperlordosis or
congenital scoliosis. More correction was obtained when a derotator
apparatus was used. Only one patient had failure of the instrumentation
that necessitated additional surgical treatment. All of the arthrodeses
resulted in osseous fusion. No patient who had idiopathic scoliosis lost
correction (average follow-up, forty-two months; range, thirty to
seventy-eight months). There were no serious complications. Lumbar lordosis
decreased an average of 24 per cent compared with the preoperative
measurement. This decrease was thought to be related to the correction of
vertebral rotation in the curve and to the surgical technique. Use of the
Zielke instrumentation resulted in excellent correction, which was not lost
postoperatively in the patients who had an idiopathic curve and which was
associated with minimum complications.