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Guidelines for Management in Limited-Resource Settings
Published in Alaaeldin (Alaa) Azmi Ahmad, Aakash Agarwal, Early-Onset Scoliosis, 2021
Harrington Rods: A lot of cases use this instrumentation without fusion with variable results, many resulting in complications, such as premature fusion, hooks cut out, rod breakage, luque wires cut out, crankshaft, and failure to stop progression, leading to failure of treatment, repeat surgeries, and sometimes worsening of the condition.
Respiratory disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Liaison with obstetric anaesthetists is important. Regional analgesia/anaesthesia where the block is high may be dangerous in a woman with limited respiratory reserve. In addition, some women have had Harrington rods inserted that may preclude regional anaesthesia.
Unusual Inherited Pulmonary Diseases Which Provide Clues to Pulmonary Physiology and Function
Published in Stephen D. Litwin, Genetic Determinants of Pulmonary Disease, 2020
Thomas Κ. C. King, Robert A. Norum
Although surgical correction of the more severe curvatures with a Harrington rod is orthopedically successful, the long-term effect on pulmonary function and on the ultimate prognosis need to be assessed in much greater detail. In particular, the question of the optimal timing of the surgery vs. the ability of the lungs to continue to grow requires further exploration.
Pneumothorax in chronically ventilated neuromuscular and chest wall restricted patients: A case series
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2018
Andrea H. S. Loewen, Raymond Tye, Karen P. Rimmer, Kristin L. Fraser
Patient characteristics are presented in Table 1. The mean age of our clinic patients developing pneumothorax was 47 ± 18 (range =24-64) years. Five patients had progressive neuromuscular conditions (Amyotrophic Lateral Sclerosis, limb girdle dystrophy, CAP myopathy, Collagen 6 related myopathy, myotonic dystrophy type 1) and one had severe chest wall restriction from kyphoscoliosis. Two patients had prior surgical fixation of the spine with Harrington rods. All patients had severe restriction on pulmonary function testing. Mean FVC at the time of the most recent pulmonary function prior to the event was 1.00 ± 0.94 L (27% of predicted). The mean patient weight was 43 ± 13 kg with BMI of 16 ± 3 kg/m2.
A new lumbar fixation device alternative to pedicle-based stabilization for lumbar spine: In vitro cadaver investigation
Published in The Journal of Spinal Cord Medicine, 2020
Cengiz Gomleksiz, Deniz Ufuk Erbulut, Halil Can, Manoj Kumar Kodigudla, Amey V. Kelkar, Eser Kasapoglu, Ali Fahir Ozer, Vijay K. Goel
Posterior lumbar segmental instrumentation using pedicle screws has long been used by spine surgeons for fixation in degenerative spine diseases, trauma and congenital/acquired spinal deformities. Posterior stabilization was first described by Albee for the treatment of Pott disease in 1911, and Hibbs described the same technique for degenerative instability in the same year.1,2 This technique could be described as interspinous posterior fixation since autografts were placed between the decorticated spinous processes. In 1934, Mixter and Barr3 hypothesized that lumbo-sciatalgia was caused by disc herniation and that the most durable and effective treatment would be “a crude pure fusion technique”. In 1962, Harrington4 proposed a novel method for treating scoliosis. Harrington’s method involved the use of metal rods and hooks for providing stability to the spine along with correcting the curvature of the spine. Later, these rods became known as “Harrington rods”. These rods were commonly used during the subsequent 30 years for scoliosis, degenerative spine and instability surgeries. A technical paradigm shift in spinal instrumentation was achieved by the introduction of transpedicular screws. Today’s commonly used contemporary transpedicular screwing technique was first used in 1970 by Roy-Camille et al.5 and in 1984 by Cotrel and Dubousset.6 Anatomical landmarks are well defined for pedicle screw insertion, and real-time image guidance by intraoperative computed tomography has improved the accuracy of screw trajectory. However, significant malposition or inadvertent course of screws remains a major concern among spine surgeons.7,8
Pregnancy in 3M syndrome
Published in Journal of Obstetrics and Gynaecology, 2018
Maria C. Cusimano, David Chitayat, Marie Injeyan, Michael Geary
The mother is a 40-year-old G2P0 seen at the Prenatal Diagnosis and Medical Genetics Program. Short stature was noted on presentation [height 132.7 cm (<3rd percentile), weight 44.3 kg, BMI 25.2] and had been evident since birth. She had never received a specific diagnosis for her skeletal findings. Her medical history was notable for scoliosis with placement of a Harrington rod at age 13, nasal polyps, and a non-functioning pituitary microadenoma. She underwent menarche at age 13 and had cycles every 28 days. Her parents were consanguineous (first cousins) but of normal stature. Her 30-year-old sister, 28-year-old brother, and non-consanguineous husband were also healthy and of normal stature.