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Radicular pain after Harrington instrumentation.

I Montane1, G L Engler

  • 1New York University Medical Center, New York.

Journal of Spinal Disorders
|March 1, 1989
PubMed
Summary

Harrington instrumentation for scoliosis can cause nerve pain due to hook compression. Removing the hardware relieved pain, and new bracing techniques may prevent this complication.

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Area of Science:

  • Orthopedic Surgery
  • Spinal Fusion
  • Pediatric Orthopedics

Background:

  • Harrington instrumentation is a common surgical technique for idiopathic scoliosis.
  • Posterior spinal fusion aims to correct spinal deformities and prevent progression.
  • Lumbar radicular pain can be a debilitating complication following spinal surgery.

Observation:

  • Three patients experienced persistent radicular and buttock pain post-Harrington instrumentation and spinal fusion.
  • Clinical evaluation revealed nerve root compression directly caused by the inferior hook.
  • Intraoperative findings showed the inferior hook encased in bone, imploded into the spinal canal due to lamina stress fracture.

Findings:

  • Surgical removal of the entire Harrington instrumentation effectively relieved nerve root compression.
  • Complete resolution of radicular pain was achieved after hardware removal.
  • The complication appears linked to the inferior hook's position and potential for mechanical failure.

Implications:

  • This case series highlights a potential complication of Harrington instrumentation in scoliosis surgery.
  • Modification of postoperative bracing with leg extensions for L4/L5 instrumentation may mitigate this risk.
  • Further research into implant design and surgical technique is warranted to minimize neurological complications.

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