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Harrington Rod

William F Lavelle, Andy A Beltran, Allen L Carl, Richard L Uhl, Khalid Hesham, Stephen A Albanese
BACKGROUND: Long-term outcomes of patients undergoing extensive fusions for adolescent idiopathic scoliosis (AIS) have conflicting results. Moskowitz found uninstrumented scoliosis fusion patients had similar back pain as a normal age matched population. Recently, long-term outcomes of patients with Harrington rod instrumentation were reviewed and found similar functional outcome scores to non-scoliosis patients, with trending toward worse outcomes when fusions extended to L4. Our study examined long-term functional outcomes of patients treated with Cotrel-Dubousset (CD) instrumentation and determined whether distal level of instrumented fusion (L4 and L5) correlate with increased back pain or lower functional level...
2016: Scoliosis and Spinal Disorders
Beth Linker
Just as the prevalence of scoliosis began to decline precipitously after World War II, American orthopedic surgeon Dr. Paul R. Harrington devised a new, invasive surgical system whereby implantable prosthetic metal rods and hooks were used to straighten curved backs. By the 1970s, "Harrington rods" had become the gold standard of surgical scoliosis care in the United States, replacing more conventional methods of exercise, bracing, and casting. This article situates the success of Harrington rods within a much larger and historically longer debate about why, when compared to those in other nations, American surgeons appear to be "more aggressive" and "knife-happy...
2016: Bulletin of the History of Medicine
Zoher Ghogawala, James Dziura, William E Butler, Feng Dai, Norma Terrin, Subu N Magge, Jean-Valery C E Coumans, J Fred Harrington, Sepideh Amin-Hanjani, J Sanford Schwartz, Volker K H Sonntag, Fred G Barker, Edward C Benzel
BACKGROUND: The comparative effectiveness of performing instrumented (rigid pedicle screws affixed to titanium alloy rods) lumbar spinal fusion in addition to decompressive laminectomy in patients with symptomatic lumbar grade I degenerative spondylolisthesis with spinal stenosis is unknown. METHODS: In this randomized, controlled trial, we assigned patients, 50 to 80 years of age, who had stable degenerative spondylolisthesis (degree of spondylolisthesis, 3 to 14 mm) and symptomatic lumbar spinal stenosis to undergo either decompressive laminectomy alone (decompression-alone group) or laminectomy with posterolateral instrumented fusion (fusion group)...
April 14, 2016: New England Journal of Medicine
Amit Jain, Hamid Hassanzadeh, Sophia A Strike, Emmanuel N Menga, Paul D Sponseller, Khaled M Kebaish
Achieving solid osseous fusion across the lumbosacral junction has historically been, and continues to be, a challenge in spine surgery. Robust pelvic fixation plays an integral role in achieving this goal. The goals of this review are to describe the history of and indications for spinopelvic fixation, examine conventional spinopelvic fixation techniques, and review the newer S2-alar-iliac technique and its outcomes in adult and pediatric patients with spinal deformity. Since the introduction of Harrington rods in the 1960s, spinal instrumentation has evolved substantially...
September 16, 2015: Journal of Bone and Joint Surgery. American Volume
Ane Simony, Emil Jesper Hansen, Leah Y Carreon, Steen Bach Christensen, Mikkel Osterheden Andersen
BACKGROUND: Since 1962 to the mid eighties the Harrington Rod instrumentation was the Golden standard for surgical treatment of Adolescent Idiopathic Scoliosis (AIS). The Boston braces were introduced in the 1970´s and are still used as a conservative treatment, for curves less than 40°. Very few long-term studies exists, focusing on the health related quality of life. The purpose of this study was to evaluate the long-term health related outcome, in a cohort of AIS patients, treated 25 years ago...
2015: Scoliosis
Takahiro Iida, Nobumasa Suzuki, Katsuki Kono, Yasumasa Ohyama, Jyunya Imura, Akihisa Ato, Satoru Ozeki, Yutaka Nohara
STUDY DESIGN: A retrospective minimum 20-year follow-up study using 4 standard self-administered questionnaires, one of which, the SRS-22 was also administered to control groups. OBJECTIVE: To evaluate long-term postoperative pain and other clinical outcomes of scoliosis correction and fusion surgery with Harrington instrumentation using Moe square-ended rods for better preservation of sagittal alignment. SUMMARY OF BACKGROUND DATA: Only a few long-term outcome studies have used standardized and validated self-administered tools, and no studies have established SRS-22 control data within their own population...
August 15, 2015: Spine
Ozgur Dede, Gokhan Demirkiran, Senol Bekmez, Peter F Sturm, Muharrem Yazici
BACKGROUND: There is no consensus on the selection of distal instrumentation levels in growing rod surgery. Many surgeons utilize the stable zone of Harrington, but there is not overwhelming evidence to support this preference. The aim of this study was to determine the value of bending/traction radiographs in selection of distal instrumentation levels of a growing rod construct in children with idiopathic or idiopathic-like early-onset scoliosis (EOS). METHODS: Twenty-three consecutive patients with idiopathic or idiopathic-like EOS who underwent growing rod surgery at 2 separate institutions between 2006 and 2011 were included...
June 2016: Journal of Pediatric Orthopedics
Phillip R Ross, Gregory P Kolovich, Joel L Mayerson
We report the case of a 61-year-old woman who was referred to our service after she received a total hip implant at another institution and was found to have a large acetabular defect from pulmonary metastasis. The patient elected to undergo palliative surgical curettage and fixation. We describe a technique to create a cement construct reinforced with Steinmann pins that reduces pain and offers improved mobility.
March 2015: American Journal of Orthopedics
E E Sharpe, K W Arendt, A K Jacob, J J Pasternak
With improvements in management and rehabilitation, more women with spinal cord injury are conceiving children. Physiologic manifestations of spinal cord injury can complicate anesthetic management during labor and delivery. Patients who delivered at Mayo Clinic, Rochester, Minnesota between January 1, 2001 and May 31, 2012 with a history of traumatic spinal cord injury were identified via electronic record search of all parturients. Eight patients undergoing nine deliveries were identified. Six deliveries (67%) among five patients (63%) involved a trial of labor...
February 2015: International Journal of Obstetric Anesthesia
Marie-France Weiner, John Russell Silver
BACKGROUND: Suspension therapy was developed by a Russian doctor, A. Motschutkovsky and at the end of the 19th century it was a popular treatment for tabes dorsalis. It was endorsed by Jean-Martin Charcot in France and Weir Mitchell in the United States; but after 10 years, it was abandoned because it proved to be useless and some patients developed paralysis. SUMMARY: The effect of suspension upon a spinal cord affected by tabes dorsalis and a healthy spinal cord has been analyzed in the light of current knowledge...
2014: European Neurology
M S Pinzur, P R Meyer, E P Lautenschlager, J C Keller, W Dobozi, J Lewis
A reproducible flexion injury was induced in ten fresh cadaver spine preparations via four-point loading with continuous recording of load-deformation characteristics and additional monitoring by high speed photography. Each spine was then stabilized with Weiss springs, Harrington distraction rods and Harrington compression rods, and tested in a same manner.13 The elastic modulus of each instrumented spine system was compared to the preinjured state and to each of the devices tested. Fixation with Harrington compression rods had the highest elastic modulus, ie, was the most stiff, of the devices tested, yet failed with the least amount of displacement...
January 1, 1979: Orthopedics
Theresa Bui, Frederic Shapiro
PURPOSE: A retrospective study involving 65 non-ambulatory patients with hypotonic neuromuscular scoliosis has assessed the effectiveness of a sacral rod/bone onlay technique for extending spinal fusion to the sacrum. METHODS: To extend posterior spinal fusion to the sacrum, we used either 1 Harrington rod and 1 Luque L rod with sublaminar wires in 14 patients (Group 1) or two rods with sublaminar wires in 51 patients (Group 2) along with abundant autograft and allograft bone covering the ends of the rods...
May 2014: Journal of Children's Orthopaedics
Stephen M Pirris, Sherri M Kimes
There are only 2 documented cases of vertebral compression fractures occurring within a solid lumbar fusion mass: one within the fusion mass after hardware removal and the other within the levels of the existing instrumentation 1 year postoperatively. The authors report a case of fracture occurring in a chronic (> 30 years) solid instrumented fusion mass in a patient who underwent kyphoplasty. The pain did not improve after the kyphoplasty procedure, and the patient developed a posterior cleft in the fusion mass postoperatively...
June 2014: Journal of Neurosurgery. Spine
Y Cotrel, J Dubousset
The authors have designed a new method of instrumentation aimed at obtaining surgical fixation of the scoliotic curve without any postoperative external immobilisation. It is particularly strong and rigid and allows adequate reduction of the curve. This technique avoids the sublaminar space and thus prevents excessive blood loss and diminishes the danger of cord damage. The instrumentation is made of two parallel rough cylindrical rods inserted independently in the convexity and concavity of the curve. If necessary, they can be bent pre-operatively...
February 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
Carol C Hasler
The history of surgical correction for adolescent idiopathic scoliosis reaches back about 100 years: the natural course of progressive, crippling and sometimes even life-threatening deformities which could not be controlled by external means called for effectual, invasive procedures. Hibbs 1911 aimed at halting progression by long, uninstrumented fusions. However, the lack of true correction, long rehabilitation times, high pseudarthrosis and infection rates, and a fusion mass which bent further once exposed to gravity again were not satisfying...
February 2013: Journal of Children's Orthopaedics
Dror Ovadia
In 1983 Howard King presented his classification system for adolescent idiopathic scoliosis (AIS) based on the experience with Harrington rod instrumentation. Curves were divided into five types and guidelines and recommendations for which levels should be instrumented were given to preserve motion as much as possible. As segmental instrumentation systems began to gain favor over the Harrington rods this system failed and led to the development of a new classification system which was presented by Lawrence Lenke in 2001...
February 2013: Journal of Children's Orthopaedics
M Shahid, T Saunders, L Jeys, R Grimer
We reviewed the outcome of patients who had been treated operatively for symptomatic peri-acetabular metastases and present an algorithm to guide treatment. The records of 81 patients who had been treated operatively for symptomatic peri-acetabular metastases between 1987 and 2010 were identified. There were 27 men and 54 women with a mean age of 61 years (15 to 87). The diagnosis, size of lesion, degree of pelvic continuity, type of reconstruction, World Health Organization performance status, survival time, pain, mobility and complications including implant failure were recorded in each case...
January 2014: Bone & Joint Journal
Ebrahim Ameri, Hasan Ghandhari, Hamid Hesarikia, Hamid Reza Rasouli, Hossein Vahidtari, Navid Nabizadeh
BACKGROUND: Since the time of Paul Harrington numerous implants have been introduced for correction of scoliosis, but none are ideal. Newer devices are very expensive, and in our country some patients cannot afford them. OBJECTIVES: The aim of this study was to compare the results of the Harrington rod (HR) device and the newer Cotrel-Dubousset (CD) device in treatment of adolescent idiopathic scoliosis (AIS). MATERIALS AND METHODS: A retrospective review assessed patients with AIS admitted for spinal curve correction treated with HR (n = 120) and CD devices (n = 138) between October 1988 to April 2001 at the Shafa Yahyaeian Hospital, Tehran, Iran...
December 2013: Trauma Monthly
Kongkhet Riansuwan, Direk Tantigate, Banchong Mahaisavariya
This report presents a surgical technique to remove a broken cannulated nail from the femur. A Harrington rod was modified for retrograde impaction of the retained fragment. The broken implant was finally removed without complication. This particular procedure was safe, simple, and promising.
2013: Case Reports in Orthopedics
Hiroyuki Yoshihara
BACKGROUND CONTEXT: Spinal instrumentation has been used for more than five decades. Since the introduction of the Harrington rod in 1962, new rod materials and concepts have been developed. Rigid rod fixation has achieved higher fusion rates than previous methods. Recently, semirigid rod fixation devices have been used for both dynamic stabilization and fusion fixation. Memory rods, which have an interesting ability to return to their pre-bent shape when the temperature increases, are expected to be used for scoliosis correction...
October 2013: Spine Journal: Official Journal of the North American Spine Society
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