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How Do You Know/Tell if Harrington Rods Have Detached?

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  • How Do You Know/Tell if Harrington Rods Have Detached?

    I had 2 Harrington rods placed in 1984ish at Sick Kids Hospital in Toronto Canada by a wonderful surgeon (Dr. Walter P. Bobechko) I have been quite fortunate that I have had little to no discomfort since. So little in fact that other then having my back assessed for possible epidural locations, I've had no further follow ups/imaging of any kind,....until this past July
    I was garage saling with my son and was sort of leaning over pointing at a box and when I went to stand straight, I 'felt' a pop that stopped me in my tracks. When I started to finish straightening up, I couldn't. I tried again, same thing. It hurt BAD, like the type of pain I had had after the surgery bad. I had to stay in that position until the ambulance came. Even standing like that hurt...moving my hand, the wind blowing...it was scary!
    I was screaming, but they got me in and to the hospital. The imaging department did T-Spine and L-Spine images and apparently nothing is wrong except for some facet joint deterioration.
    I am a former MRT student and since I have not seen my back since the surgery (and not before that I recall), I ordered my images...I was quite surprised!
    My mom, dad, and Dr Bebechko all said that I had 2 rods placed (one on either side of the spine)...my radiographs show what appears to be one rod and a pretty bad curve. The rod appears to be almost 'bowing' and detached from the spine and laying posterior to it (in behind it)
    I am wondering if my rod(s) popped loose from my spine and that was the cause of my acute pain then and my continued pain in the same spot since? The report said nothing and for me to see someone about it would probably involve a referal on my fam doctor's part (and w/o need, won't get it *sigh*)

    Does anyone have any advice/insight? Thanks so much!
    Tracy
    Last edited by MRTmum; 10-05-2010, 06:46 PM.

  • #2
    Hi MRTMum,

    Obviously I'm not a radiographer or a doctor or anything, but I've got a Harrington Rod myself and have seen plenty of images of others, and if you *are* meant to have just the one rod then I can't see much wrong with its placement from these pictures (though a lateral view of the top would be helpful). It hooks into the posterior of the spine and as I understand it, in cases where there's a serious curve the apex of the curve will still rotate away from the rod because the Harrington wasn't able to derotate the vertebrae, and there can be quite a gap! Sometimes they used Luque sublaminar wires to help bind the rod to the spine at each level, which is what I had done in the UK in 1986. I wouldn't be worried about the "bowing" of the rod either, that doesn't look unusual to me. Linda has a lot more expertise and will probably be able to tell you more.

    Toni xx

    Comment


    • #3
      Hi Tracy...

      It looks fine to me, although a lateral image of the thoracic spine would be helpful. You definitely only have one rod.

      --Linda
      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
      ---------------------------------------------------------------------------------------------------------------------------------------------------
      Surgery 2/10/93 A/P fusion T4-L3
      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

      Comment


      • #4
        ooops!

        Thanks for the info....it's very helpful!

        I thought I posted the lateral T-spine, but did the 'L' sorry...

        Here it is...

        Comment


        • #5
          Hi...

          Definitely don't see any break in the rod. Where was your pain?

          --Linda
          Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
          ---------------------------------------------------------------------------------------------------------------------------------------------------
          Surgery 2/10/93 A/P fusion T4-L3
          Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

          Comment


          • #6
            thanks again for the reply!

            It has been to the left of my L1-L2 spine. It was severe that day, and a few after,...but a cpl weeks prior to, and ever since, that one spot has been stiff and/or achy. I was given a referal for physiotherapy (which has helped a bit), but at night it gets bad enough to wake me up and/or prevent me from sleeping on my stomach. It's odd for me cause I've always been relatively pain free in th back.

            I didn't think there was anything wrong, (but I was looking at it as a 'student' - more at the shape of the vertebrae, the joint spaces etc) My mom & dad saw them and was confused because it did not look at all as Dr. Bebechko had told them (that they remember lol),and everyone else has been "woah!, your spine is so curved, what are the rods doing?"

            I wish back then I had thought to ask more questions or for papers,...something. I was 9 or 10 though and all I wanted to do at the pre-op was play with the oxygen mask lol. My only question to him was would I be able to have babies lmao!

            Comment


            • #7
              Hi...

              There's nothing obvious on the radiographs at the L1-L2 level, but the imaging isn't all that great. If the pain doesn't go away, I'd push your doctor to send you for a CT or MRI of the lumbar area.

              Hope it gets worked out.

              Regards,
              Linda
              Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
              ---------------------------------------------------------------------------------------------------------------------------------------------------
              Surgery 2/10/93 A/P fusion T4-L3
              Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

              Comment


              • #8
                Hi Tracy,

                I was kind of shocked when I saw my x-ray when I hurt my back a few years ago - I hadn't expected the Harrington rod to look like it did. My rod looks identical to yours - they just kind of look like they're floating, it's kind of weird. My difference though, is I have hooks on the other side. My surgery was in 1990, so maybe the technology had changed. I'm a fellow Canadian - had my surgery in 1990 at CHEO in Ottawa.

                My injury turned out to be a herniated disc, which won't appear on an x-ray. I had to have a CT scan to have it diagnosed. This is because discs are soft tissue which doesn't show up on an X-ray. It may be worth seeing if they'll do one of them for you.

                Just curious - do you know from where to where you're fused? And were they able to give you an epidural? I ask, because I'm now four months pregnant with my first child and will be meeting with the anaethesia department soon and am curious about what the options will be.

                Hope you're able to find some answers to your back pain!

                - Sarah
                - 39 years old
                - At age 14, curve progressed from 45 degrees to 62 degrees in two months.
                - Surgery in 1990 at the Children's Hospital of Eastern Ontario (CHEO) with Dr. Letts. Fused T5 to L2. Corrected to about 30 degrees.
                - Harrington rod
                - Herniated disc - L5/S1 - January 2008. Summer 2009 - close to making a full recovery.
                - New mommy as of February 2011
                - Second child - September 2013
                - Staying relatively painfree through physio exercises!

                Comment


                • #9
                  a day after i herniated discs (felt something "give," when it happened, but didn't know what i had done) my rheumatologist/G.P. did an Xray in his office, to find out why i was in agony...he pointed to a "fuzzy spot" on the Xray and said that was where i herniated the discs...

                  jess

                  Comment


                  • #10
                    Originally posted by SIsForSarah View Post
                    My injury turned out to be a herniated disc, which won't appear on an x-ray.
                    For me, the space between the vertebra at the point of the herniated disc in my lumbar was much smaller than between the others. Once it was pointed out it was beyond obvious. Maybe it was a particularly spectacular presentation or something but you can easily see this on a radiograph.

                    I was told it would fuse naturally and the pain would disappear at that point. I did not have a follow up radiograph and can only assume it fused. That seemed to occur after several weeks and I was pain free for about 20 years. I am guessing my recent pain in that area is due to damage to the disc above and below the fusion because nature seems to abhor even a two-level fusion in the lumbar like it abhors a vacuum.
                    Sharon, mother of identical twin girls with scoliosis

                    No island of sanity.

                    Question: What do you call alternative medicine that works?
                    Answer: Medicine


                    "We are all African."

                    Comment


                    • #11
                      hi Sharon
                      i have been told by doctors that they can tell when discs have been blown....on the X rays...one way or another...i sure could definitely see the fuzzy space...of course, my body already told me something bad had happened!

                      i hope you can escape the unrelenting, haunting pain that blown discs can cause! i fear that the pain comes back later, even if one does not re-injure the area...

                      and i don't understand when/why bones fuse...or don't...
                      i wonder why that happens to some people & not to others...?

                      hope you are feeling well...
                      jess

                      Comment


                      • #12
                        Originally posted by Pooka1 View Post
                        For me, the space between the vertebra at the point of the herniated disc in my lumbar was much smaller than between the others. Once it was pointed out it was beyond obvious. Maybe it was a particularly spectacular presentation or something but you can easily see this on a radiograph.

                        I was told it would fuse naturally and the pain would disappear at that point. I did not have a follow up radiograph and can only assume it fused. That seemed to occur after several weeks and I was pain free for about 20 years. I am guessing my recent pain in that area is due to damage to the disc above and below the fusion because nature seems to abhor even a two-level fusion in the lumbar like it abhors a vacuum.
                        Pooka: I remember you writing this on a thread a couple of years ago and I remember hoping mine would fuse too because I was in so much pain and you told me the pain went away when it fused. From what I understand, when a disc is herniated and starts leaking disc material, it decreases in size, may fuse evenutally and can be seen on an x-ray as a loss in disc height.

                        Mine, fortunately or unfortunately depending on how you look at it, didn't leak disc material. This meant that the full disc bulged out onto my nerve for quite a few months - ouch! But this also meant that I maintained disc height and now that the herniation has settled, I still have a relatively full L5/S1 disc that appeared at full disc height on my x-ray (during the herniation). It did take a CT scan to diagnose my problem because of this. Just a thought to those with a normal x-ray and radiating nerve pain who suspect a herniation.
                        - 39 years old
                        - At age 14, curve progressed from 45 degrees to 62 degrees in two months.
                        - Surgery in 1990 at the Children's Hospital of Eastern Ontario (CHEO) with Dr. Letts. Fused T5 to L2. Corrected to about 30 degrees.
                        - Harrington rod
                        - Herniated disc - L5/S1 - January 2008. Summer 2009 - close to making a full recovery.
                        - New mommy as of February 2011
                        - Second child - September 2013
                        - Staying relatively painfree through physio exercises!

                        Comment


                        • #13
                          Originally posted by jrnyc View Post
                          hi Sharon
                          i have been told by doctors that they can tell when discs have been blown....on the X rays...one way or another...i sure could definitely see the fuzzy space...of course, my body already told me something bad had happened!

                          i hope you can escape the unrelenting, haunting pain that blown discs can cause! i fear that the pain comes back later, even if one does not re-injure the area...

                          and i don't understand when/why bones fuse...or don't...
                          i wonder why that happens to some people & not to others...?

                          hope you are feeling well...
                          jess
                          Thanks Jess. Actually, when I was going through the disc herniation, I wouldn't call is unrelenting. It was 0 - 10 - 0, nothing in-between. I did have unrelenting fear of when the pain would occur and was desperate to stop it and saw a PT and even agreed to see a chiro who luckily turned out to be honest. I have screamed out in the middle of meetings without being able to stop it because it was so sudden and so intense.

                          I actually had no back pain in the intervening years even through the twin pregnancy.

                          Now, I can predictably bring on pain that will last a few days just by standing for more than a few minutes. I recently was standing around for a long time listening to other riding lessons during a riding clinic (guest instructor) while awaiting my lesson. Big mistake. My back hurt so much that for the first time I had pain in the saddle. Because of that pain, I did not get all I would have gotten out of that lesson. So I learned another lesson... sit down if if you can't see everything the instructor is talking about.

                          I have mild sciatica on the left side sometimes that I still think is related to standing around. It never seems to make it to my leg but stays higher. But each episode lasts longer and longer it seems.

                          I just would like to know where this train is heading. Unless the pain gets worse or more persistent, I'll probably only do something if it ever curtailed my riding. As I mentioned, I never had pain in the saddle until that clinic.

                          I don't know why some fuse and some don't. It's got to be driving by bone quality I would think.

                          You hang in there, Jess.
                          Sharon, mother of identical twin girls with scoliosis

                          No island of sanity.

                          Question: What do you call alternative medicine that works?
                          Answer: Medicine


                          "We are all African."

                          Comment


                          • #14
                            Originally posted by SIsForSarah View Post
                            Pooka: I remember you writing this on a thread a couple of years ago and I remember hoping mine would fuse too because I was in so much pain and you told me the pain went away when it fused. From what I understand, when a disc is herniated and starts leaking disc material, it decreases in size, may fuse evenutally and can be seen on an x-ray as a loss in disc height.

                            Mine, fortunately or unfortunately depending on how you look at it, didn't leak disc material. This meant that the full disc bulged out onto my nerve for quite a few months - ouch! But this also meant that I maintained disc height and now that the herniation has settled, I still have a relatively full L5/S1 disc that appeared at full disc height on my x-ray (during the herniation). It did take a CT scan to diagnose my problem because of this. Just a thought to those with a normal x-ray and radiating nerve pain who suspect a herniation.
                            Well that was pretty interesting. I see your point.

                            I was told I had a crushed disc at some point but I have lately be calling it a herniated disc because I thought that was the correct terminology. I am now thinking crushed and broken and leaking is probably what happened, not just herniated.

                            It happened a few months after I stopped a particular set of intense riding lessons wherein I was not sitting the trot correctly. I am 99% sure my crushed disc is sports injury related to that. Also, even people who are expert riders, over time, seem to develop lower back issues. It's shocking to me. So maybe even correct riding isn't so good for the lower back, who knows.
                            Sharon, mother of identical twin girls with scoliosis

                            No island of sanity.

                            Question: What do you call alternative medicine that works?
                            Answer: Medicine


                            "We are all African."

                            Comment


                            • #15
                              hi Sharon
                              just saw your posts from today...
                              thanks for the encouraging words!

                              i am so sorry that you have any disc problems...you have all my sympathy!!

                              am sending you a private message, so i don't hijack the thread concerning Harrington rods...

                              jess
                              Last edited by jrnyc; 10-09-2010, 11:45 PM.

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