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The crankshaft phenomenon.

J Dubousset1, J A Herring, H Shufflebarger

  • 1St. Vincent de Paul Hospital, Paris, France.

Journal of Pediatric Orthopedics
|September 1, 1989
PubMed
Summary
This summary is machine-generated.

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Posterior spinal fusion before Risser stage I for scoliosis can lead to continued curve progression, especially in younger patients. This highlights the need for considering combined anterior and posterior fusion in immature patients.

Area of Science:

  • Orthopedics
  • Spinal Surgery
  • Pediatric Orthopedics

Background:

  • Idiopathic and paralytic scoliosis often require surgical intervention.
  • Spinal fusion aims to correct and halt scoliosis progression.
  • Pre-Risser stage I fusion represents surgery in skeletally immature patients.

Observation:

  • A review of 40 spinal fusions performed before Risser stage I was conducted.
  • 39 patients underwent posterior fusion alone for scoliosis.
  • Postoperative follow-up assessed curve progression, angulation, and rotation.

Findings:

  • Posterior fusion alone in immature patients resulted in significant postoperative spinal angulation and rotation.
  • The degree of progression correlated with patient skeletal immaturity.

Related Experiment Videos

  • Continued anterior spinal growth was identified as the cause of progression, independent of pseudarthrosis or hardware failure.

    • Implications:

    • Posterior spinal fusion prior to skeletal maturity may be insufficient to control scoliosis progression.
    • Younger patients with scoliosis may benefit from combined anterior and posterior fusion techniques.
    • Further research into optimal fusion strategies for immature scoliosis patients is warranted.