Editing Scoliosis (section)

===Surgery===
In 1962, the American orthopaedic surgeon [[Paul Randall Harrington|Paul Harrington]] introduced a metal spinal system of instrumentation that assisted with straightening the spine, as well as holding it rigid while [[Spinal fusion|fusion]] took place. The now obsolete [[Harrington rod]] operated on a [[Ratchet (device)|ratchet system]], attached by hooks to the spine at the top and bottom of the curvature that when cranked would distract—or straighten—the curve. The Harrington rod obviates the need for prolonged casting, allowing patients greater mobility in the postoperative period and significantly reducing the quality of life burden of fusion surgery. The Harrington rod was the precursor to most modern spinal instrumentation systems. A major shortcoming was that it failed to produce a posture wherein the skull would be in proper alignment with the pelvis, and it did not address rotational deformity. As the person aged, there would be increased wear and tear, early onset [[arthritis]], disc degeneration, muscular stiffness, and acute pain. "Flatback" became the medical name for a related complication, especially for those who had [[lumbar]] scoliosis.<ref name="news-medical1">{{cite web | url = http://www.news-medical.net/health/Scoliosis-Surgery.aspx | title = Scoliosis Surgery | work = News-medical.net | date = 22 November 2009 | access-date = 16 January 2011 }}</ref>

In the 1960s, the gold standard for idiopathic scoliosis was a posterior approach using a single Harrington rod. Post-operative recovery involved bed rest, casts, and braces. Poor results became apparent over time.<ref name="Bridwell_2014">{{cite web |url=http://www.spineuniverse.com/conditions/scoliosis/idiopathic-scoliosis-options-fixation-fusion-thoracic-curves |title=Idiopathic Scoliosis: Options of Fixation and Fusion of Thoracic Curves | vauthors = Bridwell K |publisher=SpineUniverse |date=8 February 2013 |access-date=21 May 2014}}</ref>

In the 1970s, an improved technique was developed using two rods and wires attached at each level of the spine. This segmented instrumentation system allowed patients to become mobile soon after surgery.<ref name="Bridwell_2014"/>

In the 1980s, [[Cotrel–Dubousset instrumentation]] improved fixation and addressed [[sagittal]] imbalance and rotational defects unresolved by the Harrington rod system. This technique used multiple hooks with rods to give stronger fixation in three dimensions, usually eliminating the need for postoperative bracing.<ref name="Bridwell_2014"/>