Harrington rods for scoliosis

If you suffer from scoliosis, you will probably have looked into the various treatment options for this condition. Today, we're going to look at the pros and cons of one specific treatment method: spinal fusion surgery using Harrington rods.

What are Harrington rods?

Developed in the early 1960s by Dr Paul Harrington, the Harrington rod is a straight rod that contains a ratcheting mechanism. These rods are used in spinal fusion surgery to reduce the curvature of the patient's spine.

The rod is positioned along the concavity (inside) of the spinal curve and attached to the spine using two hooks - one attached to a vertebra at the bottom of the curve and the other to a vertebra at top of the curve. Then, employing the ratcheting mechanism, the surgeon stretches the spine to straighten the curve and fuses into position.

Do Harrington rods help to correct scoliosis?

For 20 years, Harrington rods were seen at the 'gold standard' for spinal fusion surgery - if you underwent spinal fusion surgery before the year 2000, the surgeon most likely used Harrington rods. This procedure was routinely recommended for any patients with a spinal curve exceeding 45 degrees.

These days, however, there are a number of alternatives for scoliosis patients who require surgery. You can read about these more modern methods here.

Harrington rods have been successful in many cases of scoliosis, but they also come with a number of risks and limitations.

What are the risks and limitations of Harrington rods?

As with all surgical operations, there are risks involved with the procedure described above. This intrusive operation requires the surgeon to remove spinal discs and muscle so that the rod can be inserted and screwed onto the vertebrae. The spine is then bent forcefully and fused into that position. Infection is one possible complication - other potential risks include:

  • Bending and breaking of the rod
  • Hardware migration
  • Pseudoarthrosis
  • Flat back syndrome

Furthermore, this surgery is not recommended for patients whose spines are still growing. Performing a spinal fusion on a growing child can lead to a number of complications, such as the Crankshaft phenomenon. As young spines continue to grow there is a chance the spinal curve will also change, which may mean the rod will end up causing further complications.

What are the alternatives to surgery?

In some very severe cases, surgery is the only way to ensure that a spinal curve will not get any worse. In most cases, however, there are plenty of other scoliosis treatment methods available that do not involve intrusive, potentially risky surgical procedures.

Here at the Scoliosis SOS Clinic, we offer a non-surgical scoliosis treatment programme called ScolioGold therapy, which combines a number of effective techniques to improve patient's condition. To see how effective non-surgical treatments can be, have a look at our results and see how we have reduced our patients' Cobb angles without surgical intervention.

If you have any more questions about scoliosis surgery and how our non-surgical approach can help you with your back condition, please get in touch today.

Exercise after Scoliosis Surgery

In a particularly severe case of scoliosis, surgery may be the only way to prevent the patient's spinal curvature from continuing to get worse. Spinal fusion surgery, while generally effective, is a major operation from which it typically takes months to fully recover.

After undergoing this type of surgery, it is often necessary to make some lifestyle changes in order to minimise your recovery time. For instance, bending, lifting and twisting should all be avoided in the weeks immediately following a spinal fusion procedure, as your spine and incision will need time to heal.

Later in the recovery process, you can start to consider your regular exercise routine. Many patients who undergo scoliosis surgery are able to maintain their usual lifestyle after the operation, but changes do sometimes need to be made to reduce pressure on the spinal area.

Can you exercise after scoliosis surgery?

Yes, you can, although the more important question is how long you ought to wait before exercising again. As mentioned above, heavy lifting, bending and twisting are all strictly off-limits to begin with; indeed, intense exercise of any sort is best avoided at this point. However, low-impact exercises - such as walking and swimming - will benefit both your health and the ongoing fusion process.

Before you can return to your usual sport and exercise habits, your skin will need to heal from the incision and your bones will need to fuse together again. This can take anywhere from 6-9 months. Your surgeon will be able to tell you when you're sufficiently healed, at which point you'll hopefully be able to ease back into more physically-demanding exercises and activities.

What exercises can you do after scoliosis surgery?

As a general rule, anything that puts too much pressure on your spine is best avoided after scoliosis surgery. Heavy weightlifting, high-impact sports like rugby, and exercises that involve your abs can all damage your spine again and should be removed from your exercise regime.

Exercises that involve flexion of the spine or neck, such as sit-ups and squats, can place pressure on the discs above and below the spinal fusion site. These should also be avoided as much as possible, although they can be replaced with more gentle stretching exercises.

It is best to swap high-intensity exercise for more frequent low-impact exercise after scoliosis surgery. Recommended post-surgery activities include:

  • Swimming
  • Gentle yoga
  • Bicycle rides
  • Elliptical machine training

In this way, you can still maintain an active lifestyle without fear of damaging your vertebrae, discs or spinal cord.

Here at the Scoliosis SOS Clinic, we believe that exercise is the best method for fighting spinal curvature. We treat both patients who are looking to avoid surgery and those who have already had a spinal fusion. Our non-surgical ScolioGold treatment courses combine stretches, exercises, and massages to reduce the angle of your spinal curve and improve your quality of life. Contact us now to arrange an initial consultation.

Worried that your scoliosis will prevent you from taking part in your favourite sport? Read about some of our sporty success stories here!

Surgery is often recommended once a scoliosis patient's spinal curve has progressed beyond a certain point, and in the vast majority of cases, 'surgery' means spinal fusion surgery. This procedure involves joining two or more vertebrae together to prevent the patient's curvature from growing; nowadays, this is usually achieved by fastening small metal screws called pedicle screws to the spine, then using a bone graft to 'fuse' the vertebrae together

However, while this procedure is still the standard surgical scoliosis treatment method in most parts of the world, there are a number of risks associated with spinal fusion. Though rare, the potential complications include:

  • Screws placed in the wrong positions
  • Screws breaking or coming loose
  • Dural lesion
  • Infection
  • Various neurological, pulmonary, and vascular complications

In response to the risks sometimes associated with spinal fusion, a number of other surgical scoliosis treatments have been developed, and some of these new techniques seem to becoming increasingly popular. Today, we'd like to look at three relatively new surgical procedures and why they're potentially preferable to spinal fusion surgery.

Magnetically-controlled growing rods (MCGR)

Magnetically Controlled Growing Rods

Magnetically-controlled growing rods are already being used in more than 20 countries (including the UK and the USA) to treat scoliosis in children under the age of seven. During the MCGR procedure, the surgeon fastens titanium rods to the patient's spine; these rods have a lengthening mechanism that can be operated magnetically, and after the operation itself, the patient attends a series of minimally-invasive 'distraction' procedures where a remote controller is used to lengthen the rods and correct the spinal curvature.

This effectively puts the doctor in control of the child's scoliosis until they have finished growing.

 

Stapling and tethering

Spinal Tethering Operation

Vertebral body stapling (VBS) and vertebral body tethering (VBT) are two minimally-invasive procedures that are usually performed on scoliosis patients who are still growing (e.g. teenagers and pre-teens). VBS uses malleable metal staples to join two or more vertebrae together, while VBT uses pedicle screws attached to a flexible cable at the site of the curvature. VBS is recommended for thoracic curves of 25-35 degrees and lumbar curves under 45 degrees; VBT can be used to treat thoracic curves between 35-70 degrees.

Currently available only in the UK, the USA, India, Canada and New Zealand, the tethering and stapling procedures have no major reported complications and are generally less invasive than the more commonly-seen spinal fusion procedure.

Apifix

Apifix for Scoliosis

Apifix is a small implant that is attached to the spine using just two screws. No fusion is performed, and the procedure is not very invasive, leaving a far less visible scar than spinal fusion surgery.

Apifix Scar

This procedure is ideal for adolescents with idiopathic scoliosis, especially where the curve measures 40-60 degrees. Apifix is currently available in the USA, Israel, and across Europe.

Any surgery carries risks and complications, depending on the procedure and patient presentation. If you are looking for a non-surgical alternative to spinal fusion, please contact the Scoliosis SOS Clinic today. We use an exercise-based regime called ScolioGold to correct scoliosis without any surgical intervention whatsoever. We can also assist with recovery after undergoing scoliosis surgery.

Scoliosis Surgery

Earlier this year, we answered some frequently asked questions about scoliosis surgery to provide you with more information on the spinal fusion procedure that is often used to correct severe spinal curves. Since then, we've been asked a number of other questions about this operation, so we thought we'd assemble another list of frequently asked questions to give you a little more insight into what scoliosis surgery is really like.

Q. Does scoliosis surgery hurt?

A. You won't experience any pain during the surgery because you'll be under general anaesthesia, but you may experience some discomfort after the operation. While you recover, you will be given PCA (patient-controlled analgesia) - a pump that delivers morphine or other painkillers into your system when you press a button. This will control the pain for the first few days after surgery.

Most patients are moved off PCA after 2-3 days and then begin a course of oral pain medication. When discharged from hospital, a prescription for pain medication is provided. In most cases, children are usually off medication within two weeks; however, adults may require medication at diminishing doses for weeks or even months after surgery.

Q. Does scoliosis surgery leave a scar?

A. Yes, you will be left with a scar but it will gradually fade over time. The length of the scar depends, at least in part, on how many curves there are in your spine. If you have just one spinal curve, your scar should be roughly 10 inches long. However, if you have two or more curves in your spine, your scar may begin in the middle of your shoulder blades, and may finish as far down as your pelvis. Surgeons will try to keep the scar as thin as possible by placing the sutures beneath the skin. Some surgeons may even use a special type of glue that promotes wound healing.

Q. Does scoliosis surgery make you taller?

A. Yes - but the length of your spine will not have changed. The increase in height is due to your spine being straightened and therefore appearing longer. The increase in height depends on the severity of your spinal curve.

Q. What kind of doctor performs scoliosis surgery?

A. Both orthopaedic surgeons and neurosurgeons can carry out a spinal fusion procedure. Scoliosis surgery was originally carried out exclusively by neurosurgeons, but nowadays, orthopaedic surgeons are equally well-qualified to undertake the majority of spinal operations.

Q. How long does scoliosis surgery take?

A. The spinal fusion procedure tends to take 4-6 hours, but the time can vary between patients. The surgeon will take as long as necessary to ensure the patient receives the best results.

Q. Can you exercise after scoliosis surgery?

A. Yes - in fact, exercise helps with the rehabilitation process. Physical therapy is encouraged as it stretches and strengthens the muscles around the spine, and also improves neuromuscular stability. However, it is recommended that you don't do anything too strenuous, as it could worsen your condition.

Further reading:

Scoliosis SOS is a UK-based clinic providing non-surgical treatment for scoliosis and other curvatures of the spine. Click here to learn about our treatment methods, or get in touch to arrange an initial consultation.

Magnetic Growth Rods

Spinal fusion is the most commonly-used surgical treatment for scoliosis, but there are other procedures that can be used to combat a curvature of the spine. The use of magnetic growth rods is becoming more widespread - but exactly what does this procedure entail?

What are magnetic growth rods?

The magnetic growth rods procedure is relatively new, and it has been developed to improve the traditional growing rod procedures. Usually recommended only for young patients, the procedure is performed in an outpatient clinic under the control of an externally-applied magnet control device. It has shown itself to be a relatively safe and effective procedure, and only requires a short-term follow-up.

Magnetic growth rods aim to control the patient's spinal curve during the growth and development stage, until the patient nears skeletal maturity (after 11-13 years of age).

The procedure itself consists of single or dual titanium spinal rods that contain a magnetically drivable lengthening mechanism. These rods are inserted at the two most cranial levels and the two most caudal vertebral levels for distal fusion segments. Pedicle screws are used as anchors before passing the rods subcutaneous/submuscular to connect to each fusion segment. Patients are required to undergo a post-op procedure (distraction) after the initial surgery is complete.

What happens during the post-op procedure?

The post-op procedure is not very invasive, and patients are required to undergo follow-ups for 6 weeks for distraction. An external remote controller is placed over the internal magnet, and once applied, the rotating mechanism causes the rods to lengthen, thus distracting the spine. During each distraction visit, the aim is to lengthen the spine by 1.5 to 2mm. If the patient is experiencing any pain or discomfort, the device can retract. The procedure is pretty quick, and tends to last around 30 secs to a minute. This procedure is usually performed on children under the age of 7 that have been diagnosed with early onset scoliosis.

What complications can arise?

There are fewer complications associated with magnetic growth rods than with other scoliosis surgeries, but that doesn't mean there aren't any risks involved. There is a small chance that the rod may break and cause some damage to your spinal cord. There is also a risk that the pedicle screws may come loose and pull out, and on rare occasions, the device may also fail to construct a distraction. MAGEC rods are expected to last for approximately 24 to 36 months before they have to be replaced, at which point you will have to undergo surgery again.

How can we help?

If you don't want your child to undergo this type of scoliosis surgery, or if you're looking for something to help with the rehab process, the Scoliosis SOS Clinic can help! We treat all of our patients non-surgically, treating their conditions using an exercise-based treatment method that provides unrivalled treatment success.

Please feel free to contact us to find out more about our unique treatment method, or to book an initial consultation.

Book Your Appointment >