The crankshaft phenomenon.
We reviewed 40 spinal fusions done prior to Risser stage I for idiopathic and paralytic scoliosis to evaluate postoperative curve progression. The 39 patients who had posterior fusion alone had progressive angulation and rotation of the spine over the postoperative follow-up period. The more immature the patient, the greater the resultant progression. This progression is an inevitable consequence of continued anterior spinal growth in the presence of a posterior fusion, and occurs without pseudarthrosis or hardware failure. Younger patients may require anterior and posterior fusion to achieve stable correction.
Dubousset
J
J
St. Vincent de Paul Hospital, Paris, France.
Herring
J A
JA
Shufflebarger
H
H
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D010243:Paralysis / Q000151:congenital / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D012008:Recurrence; D012447:Sacrum / Q000601:surgery; D012600:Scoliosis / Q000151:congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery