How back pain influences daily activities and quality of life: Incidence of back pain related to age.

Low back pain is a prevalent global musculoskeletal issue, with a lifetime prevalence ranging from 49% to 70% in adults. Traditionally associated with adults, recent field surveys indicate comparable prevalence rates in children and adolescents, challenging earlier assumptions. Non-specific low back pain, where the source cannot be identified through diagnostic imaging, accounts for about 80%-90% of cases. Studies have shown that over 80% of adolescents with low back pain exhibit no underlying pathology. The prevalence of low back pain in younger populations varies widely, influenced by study methodology, age, and pain types. Research suggests that back pain prevalence in adolescents increases with age, with a shift in attitudes considering it is not necessarily indicative of specific issues. Level of evidence: level V.

Investigation of Impact of Walking Speed on Forces Acting on a Foot-Ground Unit.

Static and dynamic methods can be used to assess the way a foot is loaded. The research question is how the pressure on the feet would vary depending on walking/running speed. This study involved 20 healthy volunteers. Dynamic measurement of foot pressure was performed using the Ortopiezometr at normal, slow, and fast paces of walking. Obtained data underwent analysis in a "Steps" program. Based on the median, the power generated by the sensors during the entire stride period is the highest during a fast walk, whereas based on the average; a walk or slow walk prevails. During a fast walk, the difference between the mean and the median of the stride period is the smallest. Regardless of the pace of gait, the energy released per unit time does not depend on the paces of the volunteers' gaits. Conclusions: Ortopiezometr is a feasible tool for the dynamic measurement of foot pressure. For investigations on walking motions, the plantar pressure analysis system, which uses the power generated on sensors installed in the insoles of shoes, is an alternative to force or energy measurements. Regardless of the pace of the walk, the amounts of pressure applied to the foot during step are similar among healthy volunteers.

Inter-observer and intra-observer reliability in the radiographic measurements of paediatric forefoot alignment.

BACKGROUND: Foot bones in children have more rounded shapes in radiograms than adults. Thus, the goal of this work was assessing inter- and intra-observer reliability in paediatric forefoot angle measurements. MATERIAL AND METHODS: Six forefoot angles in 34 AP standing paediatric foot radiographs were measured by 5 researchers. A classic statistical analysis with use of IBM SPSS Statistics 25 was performed and a new method with two-way analysis of variance was applied. RESULTS: Results of statistical analysis revealed the properties of a subjective assessment related to specific angles. Kilmartin's angle, calcaneus-fifth metatarsal angle and first ray angle are the most reliable; metatarsus adductus angle should be used with great caution in pediatric population. Engel's angle is the most difficult for measuring and measurement error is the highest. CONCLUSION: The power of paediatric forefoot measurements is various. Several angles are reliable, while Engle's angle is the most doubtful.

Upper Limb after Forearm Lengthening in Patients' and Physicians' Perspective.

BACKGROUND: The goal of this study was to perform a functional (subjective) and radiological evaluation of patients who had undergone forearm lengthening by distraction osteogenesis years before. MATERIAL AND METHODS: Eleven patients with forearm shortening of various etiology were enrolled. They had undergone a total of 21 lengthening procedures. A retrospective analysis of radiological data was conducted and a subjective evaluation was accomplished by using a modified QuickDASH-9 questionnaire. RESULTS: Average bone lengthening was 3.54cm, and mean lengthening index was 40.53day/cm. Eight pa-tients answered the questionnaire at a mean of 7.8yrs after the treatment. The mean questionnaire score was 9.75pts (of 36). Four patients rated the overall function of the affected limb as improved following distraction, while 3 patients were not able to see any improvement. One patient reported that the lengthening had impaired limb function. With regard to cosmetic aspects, 4 patients reported a worsening after the lengthening procedure while 3 patients reported improvement and 1 patient did not note any changes. CONCLUSIONS: 1. Despite deformities and functional limitations, patients after forearm lengthening only occasionally suffered from moderate intensity pain. 2. The radiological outcomes were positive and the rate of complications was low. 3. The radiological outcomes did not match patient-declared functional and cosmetic results.

Clinical and Radiological Evaluation of Results of Surgical Correction of Forefoot Adduction by Cuneiform and Cuboid Osteotomy Using Radiological Forefoot Measurements.

BACKGROUND: Forefoot adduction is a relatively common problem. It is usually mild or it can be effectively managed conservatively. Severe deformities may require surgical treatment. The aim of the study was to perform a clinical and radiologic evaluation of forefoot adduction correction using medial cuboid and cuneiform osteotomy with a transposed wedge. MATERIAL AND METHODS: This is a retrospective study involving 16 patients who underwent 20 procedures. Mean age at surgery was 6 years (3-13). Clinical evaluation was based on measurements of forefoot deviation and patients'/care-givers' subjective opinion. The radiologic parameters assessed comprised the first ray angle, talar-first metatarsal angle, calcaneal-fifth metatarsal angle, talocalcaneal angle, metatarsus adductus angle, and Kilmartin's angle. Results were then compared in children below and above 6 years of age. The mean duration of follow-up was 4.6 years (2-9). RESULTS: The clinical and subjective outcome was rated as good in 16 procedures and satisfactory in 4. The talar-first metatarsal angle, calcaneal-fifth metatarsal angle, metatarsus adductus angle, and Kilmartin's angle were significantly reduced, while the talocalcaneal and first ray angle remained unchanged. A significantly better correction of metatarsus adductus and talar-first metatarsal angle was achieved In children below 6 years of age compared to older patients. CONCLUSIONS: 1. Medial cuneiform and cuboid osteotomy with a transposed wedge improves both clinical and radiological parameters, especially in children under the age of 6. 2. Besides the metatarsus adductus angle, the talar-first meta-tarsal, calcaneal-fifth metatarsal and Kilmartin's angles appear to be good radiologic indicators of correction.

Spine duplication or split notochord syndrome - case report and literature review.

Context: Spine duplication is a rare condition, with various extents and severe additional anomalies. The goal of this study was to describe a unique case of a boy with split notochord syndrome who was followed up from birth until maturity. Findings: Physical examination at birth showed defects of the abdominal wall and cloacal exstrophy with visible urether outlets. A transposed anus was present in the perineal region. Split bony elements of the spine with nonpalpable sacral bone were noted. A soft, skin-covered lump, with the consistency of a lipoma, was present in the sacral area. There was asymmetry of the lower limbs: the left was hypoplastic, with a deformed foot and hip. Computed tomography revealed a normal shape of the Th12 and L1 vertebrae, whereas the L2 was split. Downward from L3, there were two vertebrae at each level, with two spinal canals. The spinal cord divided into two "semicords" at the level of L1. Neurologic status and the shape of the spine remained unchanged during puberty. The last follow-up was performed at the age of 18 years. He managed to walk independently in prosthesis with visible limping. Conclusion: Spine deformities are always suspected in neonates with lipoma in the sacral region, which may sometimes be serious. Walking ability and quality of life depend on neurologic deficits; even with long duplication and double sacrum, walking can be a feasible option.

Quantitative Analysis of Foot Plantar Pressure During Walking.

BACKGROUND There are many methods of dynamic analysis of foot loading, however, we still need a simple, easily applicable system for foot plantar pressure analysis. In this study we asked the question: "Can a new system for foot evaluation, the ITE System, provide a good quantitative dynamic foot pressure analysis? Can it be used in clinical practice?". MATERIAL AND METHODS Twenty healthy volunteers, 8 females and 12 males, aged 20 to 25 years old took part in this study. Normal static foot loading was tested using a typical pedobarographic platform, followed by a dynamic analysis using the foot-pressure ITE System. A new algorithm for data analysis (from 8 sensors) was proposed. RESULTS The sum of all maximal values from sensors was 11.71 N mean, with relatively low standard deviation (SD) of 1.81. Loading of sensor 1 (heel) was the highest - on average 29.84%. Sensor 2 (medial midfoot) received the lowest loading - normal range for this segment would be 0-4%. The manner of loading heel/toes, dynamics of changes in loading during gait was quite diverse; when analyzing courses of changes on sensors, 4 gait patterns were observed. CONCLUSIONS Use of the ITE System creates a new possibility for dynamic foot evaluation, drawing from pedobarography and methods of gait analysis. The proposed data analysis algorithm is simple and can be applied in all cases. Normally, 30% of the sum of all pressures during stance phase falls on the rearfoot; 39% falls on forefoot.

The titanium-made growth-guidance technique for early-onset scoliosis at minimum 2-year follow-up: A prospective multicenter study.

BACKGROUND: The management of early-onset scoliosis (EOS) remains a serious challenge in pediatric orthopedics. The growth-guidance system (GGS) is a surgical option that allows continuous growth along a rod, averting the need for repeated operative lengthening. OBJECTIVES: The objective of this study was to evaluate the outcomes of the GGS in the treatment of EOS. MATERIAL AND METHODS: A prospective study, including 81 patients from 4 departments treated with this method from 2013 to 2015, was conducted with a minimum follow-up period of 24 months. The follow-up data of 57 patients was available, thus the drop-out rate was 29.63%. There were 44 girls with a mean age of 10.03 years and 13 boys with a mean age of 8.04 years. RESULTS: The mean preoperative Cobb angle was 65.3° (range 36°-139°) was corrected to 23.7° (2°-94°), and at the end of the 2-year follow-up increased to 30.7° (8°-93°). The predominant proximal level of instrumentation was T5 and the distal was L1. The combined length of T1-T12 and T12-S1 increased on average by 33.19 mm in 24 months. The overall rate of serious complications was 43.86%. The most prevalent device-related complications were: the dislodgement of top screws because of the short length of the rod (14 cases), the implant failure (11 cases) and loss of correction (9 cases). CONCLUSIONS: The results show that the GGS used in this study allows for a good and stable correction while preserving the ability of the spine to grow in at least a 2-year follow-up. The complication rate is acceptable and comparable with other growth-friendly techniques. To date, this is the largest successful study on the use of titanium-made GGSs.

Atypical caudal regression syndrome with agenesis of lumbar spine and presence of sacrum - case report and literature review.

CONTEXT: Caudal regression syndrome is a rare disorder, not well described in the literature. FINDINGS: Authors treated two patients with congenital absence of thoracolumbar vertebrae and lower limbs paraplegia. Patients had hypoplasia of the lower trunk and extremities with motion between upper and lower torso. Imaging showed caudal spine agenesis, but cleft sacrum was present. Due to severe kyphotic deformity and spinal instability, deformity correction and posterior fusion was performed at the age 6 and 8. Finally, fusion was achieved in one case and stable but non-fusion kyphotic posture was observed in second. CONCLUSION: surgery in caudal regression syndrome is challenging and bears high risk of complications.

Effectiveness of Treatment of Idiopathic Scoliosis by SpineCor Dynamic Bracing with Special Physiotherapy Programme in SpineCor System.

BACKGROUND: The SpineCor dynamic brace for the treatment of idiopathic scoliosis is designed to maintain the correct position of the spine and a new movement strategy for 20 hours per day. The SpineCor exercise system intensifies and complements the brace treatment. This study evaluated the effectiveness of a comprehensive treatment of idiopathic scoliosis involving the SpineCor system. MATERIAL AND METHODS: The study assessed a group of 40 patients (38 girls and 2 boys) with idiopathic scoliosis treated with the SpineCor brace. The average age at beginning of treatment was 13.1 yrs (10-15). Minimum treatment time was 18 months. 28 participants met the SRS criteria. Angles of the curve before and after bracing based on imaging studies were measured at the beginning and end of the treatment, analyzed and compared. Rehabilitation focused on teaching active corrective movement throughout the brace treatment. A control group was formed of 33 patients, including 21 meeting the SRS criteria, who used the SpineCor dynamic brace but did not participate in the associated exercise programme. RESULTS: Among patients from the exercise group who met the SRS criteria, 25% demonstrated reduced curve angles, 35.7% demonstrated curve progression and 39.3% showed stabilization (no change). Among patients meeting the SRS criteria from the control group, a decrease in curve angle was observed in 14.3% of the patients, curve progression in 57.1% and stabilization in 28.6%. CONCLUSIONS: 1. The addition of a dedicated physiotherapy programme to SpineCor dynamic bracing improves the chances of obtaining a positive outcome. 2. It is necessary to further analyse the course of the comprehensive treatment, also with regard to other types of braces and kinesiotherapy programmes.

Cervical spine surgery in patients with diastrophic dysplasia: Case report with long-term follow-up.

Cervical kyphosis in diastrophic dysplasia (DTD) is a very dangerous deformity which may lead to compression of neural structures resulting in tetraplegia or even. Treatment of this deformity is usually surgical, but no long-term follow-up studies are presented in the literature. Authors present a case of two children with DTD who underwent anterior corpectomy due to severe cervical kyphosis. The kyphotic deformity was corrected and the normal spinal canal width was restored. The effects of the correction remained stable for respectively 6 and 10 years of the follow-up period. The unique follow-up confirms that this type of intervention leads to an effective and long lasting results. Significant cervical kyphosis in patients suffering from DTD may be treated surgically using anterior approach even in young children with a favorable and lasting results.

Severe Thoraco-lumbar Kyphoscoliosis Associated with Osteoporosis in Siblings - Case study.

The incidence of scoliosis among patients with certain systemic diseases is much higher than in the general population. Moreover, the onset of the scoliosis is in early childhood before the age of 5 and the deformity reaches extreme values. We present the clinical course of two siblings with multiple musculoskeletal deformities, osteoporosis, severe kyphoscolisis and an undiagnosed systemic disease. The onset of scoliosis was in the first months of life of both children, with a marked progression about the 8th month of life. Due to lower limb deformities, ambulation was delayed until the 5th year of life in the male sibling, and the girl remains non-ambulant. Both children had osteoporosis, which caused numerous fractures of the upper and lower limbs. Due to progression of the spinal deformity the boy underwent a posterior hemispondylodesis with instrumentation at the age of 7. The girl also underwent surgery at the age of 7, but instrumentation could not be placed successfully due to inadequate bone quality. The last follow-up to date has been at the age of 12 years for the female patient and 20 years for the male patient. The spinal deformity in the female has not progressed during the last 2-3 years. She has been on bisphosphonate therapy for two years and no new fractures have been noted. The male patient has undergone multiple surgeries for lower limb deformities and is an independent walker. His scoliosis remains stable, but a minor progression of kyphosis has been noted in the last year. The history of the two patients shows that not all early-onset deformities can be effectively treated and that osteoporosis is a crucial obstacle to this treatment.

Surgical management of moderate adolescent idiopathic scoliosis with ApiFix®: a short peri- apical fixation followed by post-operative curve reduction with exercises.

Surgery in adolescent idiopathic scoliosis (AIS) is a major operative intervention where 10-12 vertebrae are instrumented and fused. A smaller motion preserving surgery would be more desirable for these otherwise healthy adolescents. The ApiFix® system is a novel less invasive short segment pedicle screw based instrumentation inserted around the apex of the main curve. The system has a ratchet mechanism that enables gradual postoperative device elongation and curve correction. The ratchet is activated by performing specific spinal exercises. The unique features of the device allow curve correction without fusion. The system which has a CE approval was employed in adolescents with main thoracic curves. More than a dozen of ApiFix surgeries have been performed so far. The preoperative Cobb angle was 45° ± 8, and 25° ± 8 at final follow up. The following is a report on three adolescent females aged 13-16 years with curves between 43°-53° and Risser sign of 1-4 who underwent surgery with ApiFix®. Two pedicle screws were inserted around the curve apex and the ratchet based device with polyaxial ring connectors was attached to the screws. No fusion attempt was made. Operative time was around one hour. Two weeks after surgery the patients were instructed to perform Schroth like daily exercises with the aim of rod elongation and gradual curve correction. Patients were followed between 6 months to 2 years. Curves were reduced and maintained between 22- 33°. Patients were pain free and were able to perform their spinal exercises. Postoperative gradual elongation of the device was observed. No screw loosening or rod breakage were observed. No adding on or curve progression was seen. Three factors may contribute to the ApiFix® success: polyaxial connections that prevent mechanical failure, gradual curve correction by spinal motion and spinal growth modulation. The ApiFix® system allows managing moderate AIS with a simple and minor surgical intervention. Recovery is rapid with negligible motion loss. It allows gradual and safe curve correction with high patient satisfaction. It may also serve as an internal brace for AIS.

Comparison of Postoperative Period in Patients with Pectus Excavatum Treated with Nuss Technique and Ravitch Technique.

BACKGROUND: Pectus excavatum (PE) is the most common defect of the chest wall. Surgery for PE can be performed with an open or endoscopic technique. The choice of the surgical approach influences the postoperative course. The aim of the paper is to analyze the postoperative period in two groups of patients treated for PE. Group 1 consisted of patients who underwent endoscopic surgery, and Group 2 was composed of patients who underwent open surgery. A secondary aim is to compare the surgical outcomes between the two groups. MATERIAL AND METHODS: The study group consisted of 40 patients treated in a single centre that uses a uniform postoperative analgesic protocol. The duration of surgery, blood loss, duration of hospital stay, complications, pain intensity and consumption of opioid and non-opioid analgesics were analyzed. The mean duration of follow-up was 9 months (6 -25 months). RESULTS: Age at surgery, weight and height did not differ between the groups. In Group 1 the duration of surgery and blood loss were lower than in Group 2. In Group 1 complications occurred in 25% of the patients. Pain intensity was higher in Group 1 (4.23 vs. 3.67), as was the consumption of strong opioids (0.52 mg/kg body weight vs. 0.25 mg/kg body weight). Subjective evaluation was satisfactory in 85% of the patients in Group 1 and 90% in Group 2. CONCLUSIONS: 1. Both techniques led to a satisfactory outcome. 2. The duration of surgery and blood loss were higher in the open surgery group, but pain intensity and consumption of strong analgesics were higher among the patients treated with the endoscopic technique. 3. Preparation for surgery should involve planning appropriate analgesic treatment in the post-operative period.

[Long-term consequences of resection of 1/3 proximal epiphysis of child's right tibia--a case study]. / Odlegle nastepstwa resekcji 1/3 nasady blizszej kosci piszczelowej prawej u dziecka--opis przypadku.

Authors report a case of a patient with varus deformity of right knee, caused by wide resection of proximal metaphysis and epiphysis of right tibia. Afore mentioned procedure led to loss of right knee joint integrity, with its lateral instability, shortening, and axis deviation of right tibia. Surgical treatment of this complications was performed in several stages and took about 5 years, starting from temporal, lateral hemiepiphysiodesis of proximal tibial epiphysis, subacute epiphysiolysis of proximal tibial epiphysis and high valgus tibia osteotomy, at the end finished with medial tibia condyle reconstruction with autogenic graft and osteoconductive substances. The proper mechanical and anatomical axis of the right limb, with full stability and movement of right knee was achieved after those surgeries. The process of treatment of lower extremity axis deviation takes long time, frequently involves several surgeries and needs firm cooperation between doctor and patient.

[Methylprednisolone- acute spinal cord injury, benefits or risks?]. / Metyloprednizolon ­ ostre urazy rdzeniakregowego, korzysci czy zagrozenia ?

Methylprednisolone is a synthetic glucocorticoid with a potent and long-acting anti-inflammatory, antiallergic and immunosuppressant. Its mechanism of action of methylprednisolone is the result of many cellular changes. Methylprednisolone is used in many diseases, such as rheumatic diseases, autoimmune diseases, allergic, anaphylactic shock, asthma. Methylprednisolone was also used in patients with spinal cord injury, in order to minimize neurological damage. While in the above mentioned fields of medicine is undeniable role of methylprednisolone, whereas its use in the treatment of traumatic spinal cord injury within the last few years raises a lot of controversy, and in most cases, the side effects of its use outweigh the potential benefits. 

Validation and cross-cultural adaptation of the Polish version of the Oswestry Disability Index.

STUDY DESIGN: Validation of a translated, culturally adapted questionnaire. OBJECTIVE: To translate and culturally adapt a Polish version of the Oswestry Disability Index (ODI) and to validate its use in Polish patients. SUMMARY OF BACKGROUND DATA: The ODI is among the most popular questionnaires used to evaluate back pain-related disability. To our knowledge no validated Polish version of the index was available at the time our study was initiated. METHODS: The questionnaire was translated and culturally adapted by 2 independent translators and approved by expert committee. Final version was included in the booklet consisting in addition of a previously validated Roland-Morris disability questionnaire, VAS for low back and leg and 3 Likert scale questions (pain medications, pain frequency, disability). It was tested on 169 patients with chronic low back pain, 164 (97%) of them were enrolled, and 84 of 164 (53%) returned the completed retest booklet within 2 to 14 days after the baseline test. There were no differences between the 2 groups in demographic and clinical parameters. Test-retest reliability, internal consistency, and construct validity were investigated. RESULTS: The mean ODI (standard deviation [SD]) was 48.45 (18.94); minimum 2, maximum 94. The Cronbach α for baseline questionnaires (n = 164) was 0.90. Concurrent validity, measured by comparing ODI responses with the results of the Roland-Morris disability questionnaire score was very good (r = 0.607, P < 0.001). The correlation with VAS back was fair (r = 0.37, P < 0.001) and with VAS leg was good (r = 0.56, P < 0.001). The tested ODI had excellent test-retest reliability, the intraclass correlation coefficient was 0.97 and standard error of measurements was 3.54, the resulting minimal detectable changes at the 95% confidence level was 10. CONCLUSION: The results of this study indicate that the Polish version of the ODI is a reliable and valid instrument for the measurement of disability in Polish-speaking patients with lower back pain.

Cross-cultural adaptation and validation of the Polish version of the core outcome measures index for low back pain.

PURPOSE: The core outcome measures index (COMI) is a short, multidimensional outcome scale validated for the use by patients with spinal disorders. It is a recommended instrument in the Spine Society of Europe Spine Tango Registry. The purpose of this study was to produce a cross-culturally adapted and validated Polish COMI. METHODS: The cross-cultural adaptation was carried out using the established guidelines. One-hundred and sixty-nine patients with chronic low back pain were enrolled, 89 took part in the reproducibility part of the study. Data quality, construct validity and reproducibility were assessed. RESULTS: The quality of data was very good with very few missing answers and modest floor effect. Reliability expressed as intraclass correlation coefficient (ICC) was 0.90 (95 % CI 0.85-0.93) for the overall COMI score and for most of the individual core items. The minimum detectable change (MDC95%) was 1.79. CONCLUSIONS: The Polish version of COMI showed a favorable reproducibility similar to that of previously tested language versions. The COMI scores correlated sufficiently with existing measures. This version of the COMI is a valuable instrument for the use by Polish-speaking patients with spinal disorders.

Spine deformities in patients with Ehlers-Danlos syndrome, type IV - late results of surgical treatment.

BACKGROUND: Spinal deformities in Ehlers-Danlos syndrome are usually progressive and may require operative treatment. There is limited number of studies describing late results of surgery in this disease. METHODS: This is a retrospective study of the records of 11 patients with Ehlers-Danlos syndrome type IV, treated surgically between 1990 and 2007. All patients underwent surgical treatment for spinal deformity. Duration of operation, type of instrumentation, intraoperative blood loss, complications and number of additional surgeries were noted. Radiographic measurement was performed on standing AP and lateral radiographs acquired before surgery, just after and at final follow up. RESULTS: The mean follow up period was 5.5 ± 2.9 years (range 1-10 years). The mean preoperative thoracic and lumbar curve were 109.5 ± 19.9° (range 83° - 142°) and 75.6 ± 26.7° (range 40° - 108°) respectively. Posterior spine fusion alone was performed on 6 patients and combined anterior and posterior fusion (one- or two stage) on 5 cases. Posterior segmental spinal instrumentation was applied with use of hooks, screws and wires. The mean postoperative thoracic and lumbar curve improved to 79.3 ± 16.1° (range 56° - 105°) and 58.5 ± 27.7° (range 10° - 95°) respectively, with a slight loss of correction during follow up. The average thoracic and lumbar correction was 26.4 ± 14.9% (range 5.3 - 50.4%) and 26.3 ± 21.2% (range 7.9 - 75%). Postoperatively, the mean kyphosis was 79.5 ± 40.3° (range 21° -170°), and lordosis was 50.8 ± 18.6° (range 20° -79°). Hyperkyphosis increased during follow up while lordosis remained stable. Mean Th12-L2 angle was -3.5 ±9.9° (range -19° - 15°) postoperatively and did not change significantly during follow up. CONCLUSIONS: Huge spinal deformities in patients with Ehlers-Danlos syndrome require complex and extensive surgery. There is a big risk of sagittal imbalance in this group.

[Scoliosis in Rett syndrome--own experience]. / Skolioza u chorych z zespolem Retta--doswiadczenia wlasne.

Rett syndrome (RS) is a rare genetic disorder affecting only girls. The prevalence is 1:15000. The most characteristic features of RS are: lack of development, wringing of the hands. Musculoskeletal system is also affected and scoliosis remains the biggest challenge. Aim of paper is to describe the curve progression pre-operatively, course of surgery and finally radiological and subjective results of treatment. Postoperative follow-up was 3.1 year. We describe a series of 9 girls with RS and scoliosis treated surgically in single Institution. All presented scoliosis that increased with a rate of mean 16.1 degrees per year. Preoperatively curves ranged from 52 degrees up to 120 degrees Cobb angle. Curve pattern was similar in all cases, long thoraco-lumbar curve with thoracic hyperkyphoisis. All girls underwent surgery. Posterior fusion with Luque-Galvestone technique, posterior hybdrid fusion or anterior fusion was performed depending on the degree of scoliosis. Surgery and postoperative period were uneventful. Mean blood loss was 650 ml; mean obtained correction was 38%, with minimal correction loss at final follow-up. No additional surgery was required. Most caregivers were subjectively satisfied with surgery. Scoliosis in RS patients is progressive, with a high annual rate. Surgery should be performed I cases of curves of 40-50 degrees in specialized centers. The procedure is safe, and does not affect general condition nor deteriorate neurological status. In non-ambulant patients fusion should be carried out to the pelvis.