Scoliosis - Braces

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The Harrington procedure is very difficult to undergo, particularly for young people, and although the operation can achieve a 50% correction of the curve, studies have reported a 10 - 25% loss in this correction over time. The procedure does not correct the rotation of the spine and, therefore, does not improve an existing rib hump that was caused by the rotation. The operation does not interfere with normal pregnancies and deliveries later in life.

Certain complications may occur from this procedure:

• About 40% of Harrington patients have a condition called the flat back syndrome, because the procedure eliminates normal lordosis (the inward curving of the lower back). Flat back syndrome from the Harrington procedure does not cause any immediate pain. In later years, however, the disks may collapse below the fusion, making it difficult to stand erect, and the condition can cause significant pain and emotional distress.
• Studies have reported that 5 - 7 years after their surgery, between a fifth and a third of patients who had the Harrington procedure experienced low back pain. In such cases, however, the pain was not severe enough to interfere with normal activities and did not require additional surgery.
• Children younger than age 11 whose skeleton is immature and who have the Harrington procedure have a fairly high risk for a specific curve progression called the crankshaft phenomenon. This condition occurs when the front of the fused spine continues to grow after the procedure. The spine cannot grow longer, so it twists and develops a curvature. However, in one study that followed patients for 5 - 16 years, crankshaft curve progression was moderate, with the Cobb angle averaging 9 degrees and rotation averaging 7 degrees.

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Cotrel-Dubousset Procedure. The Cotrel-Dubousset procedure corrects not only the curve but also possibly rotation, and it does not cause flat back syndrome.

With this procedure, a surgeon cross links parallel rods for better stability in holding the fused vertebrae. Patients often go home in 5 days and may be back in school in 3 weeks.