The Journal of Bone and Joint Surgery, Vol 71, Issue 7 1053-1057, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Late neurological complications of Harrington-rod instrumentation
DD Hales, EG Dawson and R Delamarter
Division of Orthopaedic Surgery, University of California, Los Angeles School of Medicine 90024-1749.
From our patients who had idiopathic scoliosis, we identified a subset of
eighteen in whom Harrington rods were used for fixation down to the fifth
lumbar vertebra. In five of these patients, low-back pain, sciatica, and
other neurological problems developed at two to thirty-two months after
arthrodesis. These complications were caused by migration of the caudad
hook into the spinal canal. The migration was probably caused by a
combination of lumbosacral lordosis and mobility of the fifth lumbar
vertebra (the most caudad mobile segment) on the segment below, resulting
in weakening of the lamina of the fifth lumbar vertebra. After removal of
the hardware, all patients had improvement of the lumbosacral and radicular
pain as well as resolution of the neurological abnormalities.