Harrington-Bobechko instrumentation in the treatment of scoliosis: a preliminary report

A dual hook system devised by Bobechko for use with Harrington and Moe distraction rods to eliminate postoperative orthotic support was employed in the surgical treatment of 57 patients with progressive scoliosis. Mean follow-up time was 33 months (range 15 to 56 months). Average correction was 51%, with an average loss of correction of 8 degrees. Five patients required reinstrumentation, two of whom had dislodgement of both upper hooks during the first postoperative week; the other three had rod breakage which occurred 3 to 20 months after surgery. The results indicate that the dual hook system provides greater security of fixation than a single hook construct, but has the disadvantage of bulkiness, making it prominent in thin patients. Postoperative protection with bracing for 6-9 months continues to be recommended to guard against instrument failure.