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tonibunny
3rd April 2007, 02:15 PM
Hi everyone,

I thought I'd draw your attention to this.

Crankshaft Phenomonen can happen when a young child (at Risser 0) has surgery for scoliosis but only has a posterior fusion.

The front of the spine continues to grow, causing the whole spine to curve and twist as it is constrained by the fusion at the back of the vertebrae.

In order to prevent this, most young children will also have an anterior release and fusion. This means that the discs are removed from the front of their spine, and the growth plates of the vertebrae are damaged so they can no longer grow. Bone chips are packed in and around the front of the vertebrae in order to fuse the front just as the back is fused. This surgery is done prior to the posterior fusion.

Take a look at my x-rays if you like.....Mr Edgar packed my thoracic spine with bone front and back to ensure that this would never happen to me. My spine is rock solid :-)

If your young child is facing spinal fusion, PLEASE ensure that your surgeon is going to do the anterior procedure too. I was shocked to find a lady on another site, whose doctor has told her that he "could fuse her child, but because she's young she may develop Crankshaft Phenomonen and she'd have to have surgery further down the line to correct the curve that would develop". This REALLY scares me - that surgeons can be so ignorant! He's obviously heard of Crankshaft Phenomonen but somehow does not understand how it can be prevented!

andrea
3rd April 2007, 02:19 PM
Thanks for highlighting this Toni. I've never heard of it before, but can understand how it happens now that you've mentioned it. Hopefully all of us here will escape the fusion for our kids for a while yet, but it's very useful to know for the future. Thanks!!

GillyG
3rd April 2007, 08:51 PM
I'd heard of this phenomenon but wasn't quite sure about how it happened, so thanks for educating me! It hadn't actually occurred to me that a posterior fusion would always confine itself to the rear of the spine - I kind of assumed once the bone started growing between the vertebrae it would carry on round the front. Duh!

titch
5th April 2007, 10:44 AM
Actually, in many cases over time it does. It doesn't happen to everyone, but a significant number of people will a few years after a posterior fusion have near total ossification of the discs. It takes years though, and isn't guaranteed - some of it may also depend on how exactly they pack the bone for the posterior fusion I believe.

titch
5th April 2007, 10:44 AM
Actually, in many cases over time it does. It doesn't happen to everyone, but a significant number of people will a few years after a posterior fusion have near total ossification of the discs. It takes years though, and isn't guaranteed - some of it may also depend on how exactly they pack the bone for the posterior fusion I believe.