Abstract
We report a unique complication caused by the rod of a Harrington instrumentation device, which resulted in spinal stenosis and myelopathy. A literature review revealed no previous causes of direct spinal cord impingement caused by the rod of a Harrington device. In this case, years after the initial operation, the rod penetrated the lamina at the junction between a thoracic and a lumbar curve, causing spinal stenosis and myelopathy. We conclude that regular control of the position of the device and awareness of possible late neurological complications are necessary to identify such complications as early as possible.
Key words: Scoliosis, surgery Spinal fusion, complications, Spinal fusion, instrumentation
Full Text
The Full Text of this article is available as a PDF (613.6 KB).
References
- 1.Been HD, Kalkman CJ, Traast HS, Ongerboer de Visser BW. Neurologic injury after insertion of laminar hooks during Cotrel-Dubousset instrumentation. Spine. 1994;19:1402–1405. doi: 10.1097/00007632-199406000-00017. [DOI] [PubMed] [Google Scholar]
- 2.Bernard TN, Johnston CE, Roberts JM, Burke SW. Late complications due to wire breakage in segmental spinal instrumentation. J Bone Joint Surg [Am] 1983;65:1339–1345. [PubMed] [Google Scholar]
- 3.Court-Brown CM, McMaster MJ. Pseudarthrosis: a late cause of paraparesis after scoliosis surgery. J Bone Joint Surg [Am] 1982;64:1246–1248. [PubMed] [Google Scholar]
- 4.Curtis RS, Dickson JH, Harrington PR, Wendell DE. Results of Harrington instrumentation in the treatment for severe scoliosis. Clin Orthop. 1979;144:128–134. [PubMed] [Google Scholar]
- 5.Dove J. Segmental wiring for spinal deformity. A morbidity report. Spine. 1988;14:229–231. doi: 10.1097/00007632-198902000-00016. [DOI] [PubMed] [Google Scholar]
- 6.Eismont FJ, Simeone FA. Bone overgrowth (hypertrophy) as a cause of late paraparesis after scoliosis fusion. J Bone Joint Surgery [Am] 1981;63:1016–1019. [PubMed] [Google Scholar]
- 7.Guillemin F, Czomy A, Pouewl J. Sciatic nerve compression by hematoma: case report of a late complication of Harrington's operation. Spine. 1991;16:237–239. [PubMed] [Google Scholar]
- 8.Hales DD, Dawson EG, Delamarter R. Late neurological complications of Harrington-Rod instrumentation. J Bone Joint Surg [Am] 1989;71:1053–1057. [PubMed] [Google Scholar]
- 9.Johnston CE, Happel LT, Norris R, Burke SW, King AG, Roberts JM. Delayed paraplegia complicating sublaminar segmental spinal instrumentation. J Bone Joint Surg [Am] 1986;68:556–563. [PubMed] [Google Scholar]
- 10.Kornberg M, Herndon WA, Rechtine GR. Lumbar nerve root compression at the site of hook insertion: late complication of Harrington rod instrumentation for scoliosis. Spine. 1985;10:853–855. doi: 10.1097/00007632-198511000-00015. [DOI] [PubMed] [Google Scholar]
- 11.MacEwen GD, Bunnell WP, Sriram K. Acute neurological complications in the treatment of scoliosis. J Bone Joint Surg [Am] 1975;57:404–408. [PubMed] [Google Scholar]
- 12.Michel CR, Lalain JJ. Late results of Harrington's operation. Spine. 1985;10:414–419. [PubMed] [Google Scholar]
- 13.Moskowitz A, Moe JH, Winter RB, Binner H. Long-term follow-up of scoliosis fusion. J Bone Joint Surg [Am] 1980;62:364–375. [PubMed] [Google Scholar]
- 14.Savini R, Silvestre M, Gargiulo G. Late paraparesis due to pseudarthrosis after posterior spinal fusion. J Spine Disord. 1990;3:427–432. [PubMed] [Google Scholar]
- 15.Schlenzka D, Poussa M, Muschik M. Operative treatment of adolescent idiopathic thoracic scoliosis. Clin Orthop. 1993;297:155–160. [PubMed] [Google Scholar]
- 16.Thompson GH, Wilber RG, Shaffer JW, Scoles PV, Nash CL. Segmental spinal instrumentation in idiopathic scoliosis. A preliminary report. Spine. 1985;10:623–630. doi: 10.1097/00007632-198509000-00006. [DOI] [PubMed] [Google Scholar]
- 17.Wilber RG, Thompson GH, Shaffer JW, Brown RH, Nash CL. Postoperative neurological deficits in segmental spinal instrumentation. J Bone Joint Surg [Am] 1984;66:1178–1187. [PubMed] [Google Scholar]