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Distant Harrington rod migration 35 years after implantation
Robert K Lark1, Adam M Caputo, Christopher R Brown
1Department of Orthopaedic Surgery, Duke University Medical Center, 200 Trent Drive, 5309 Duke Clinic Building, Durham, NC 27710, USA.
Summary
A rare Harrington rod complication, rod migration, occurred 35 years after scoliosis surgery. Sigmoidoscopy successfully removed the migrated rod from the rectum, leading to full recovery.
Area of Science:
- Spinal Surgery
- Medical Device Complications
- Gastrointestinal Surgery
Background:
- Harrington rods have been a standard treatment for scoliosis since the 1950s.
- While effective, rare complications like hardware loosening and migration can occur.
- This case highlights a delayed and unusual presentation of Harrington rod failure.
Observation:
- A 50-year-old woman presented with new-onset lower extremity sensory changes.
- Imaging revealed a Harrington rod, implanted 35 years prior, had migrated distally.
- The migrated rod had penetrated the rectal wall.
Findings:
- The Harrington rod failed after 35 years of implantation.
- The rod migrated significantly, causing rectal perforation.
- Sigmoidoscopy provided direct visualization and facilitated safe hardware removal.
Implications:
- This case underscores the potential for very late-onset complications from spinal instrumentation.
- Sigmoidoscopy can be an effective tool for removing distally migrated rectal foreign bodies.
- Awareness of such rare complications is crucial for long-term patient follow-up after scoliosis surgery.
