Psychological evaluations of patients operated for idiopathic scoliosis by the Harrington method

A study group of 204 patients operated for idiopathic scoliosis by the Harrington method at The Orthopedic Hospital of the Invalid Foundation (Orton) between 1970 and 1975 was studied to evaluate the integration of these patients into society regarding work outside the home, and to evaluate the patients' adaptation to their illness and factors relating to this adaptation. A brief intelligence test was also given. The mean age at the time of the first operation was 14 years, and at the time of follow-up it was 33 years. Eighty-four percent of the patients were female. The patients completed a questionnaire, which was also sent to an age and gender matched control group. The results show that these patients with idiopathic scoliosis appear to be predominantly content with their lives. These scoliosis patients tend to form families later in life than the controls, and have fewer and less satisfying sexual relationships than the controls. These scoliosis patients feel that their illness has mostly influenced their participation in work outside the home and their partaking in physical activities, but these influences were slight and also influenced by education. The studied patients had some fears about the heredity of their illness, but only those dissatisfied with their lives let it influence their childbearing.

Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis

The course and outcome of 142 pregnancies in 146 patients operated between 1970 and 1975 by the Harrington method for idiopathic scoliosis were studied to determine the effects of scoliosis on pregnancy and childbirth and the effects of pregnancy on the remaining fused and unfused scoliotic curvatures. Occurrence of and sick leave due to low back pain during pregnancy was determined. The patients, all originally treated at the Orthopaedic Hospital of the Invalid Foundation (Orton) in Helsinki, Finland, were invited to a clinical and radiological re-examination on average 19 years following surgery. The results show that pregnancy does not significantly increase fused scoliotic curvatures nor the remaining unfused curvatures. A somewhat higher proportion of children (23%) were delivered by cesarean section than in the general population (15%; P < 0.01), but this result should only be taken as suggestive. Rates of complications of pregnancy and in labor did not differ from those in the background population. The offspring were healthy. Low back pain during pregnancy occurred in about 40% of our patients, but was severe enough to cause sick leave only in 11% of the pregnancies.