Document Detail

Posterior arthrodesis in the skeletally immature patient. Assessing the risk for crankshaft: is an open triradiate cartilage the answer?
MedLine Citation:
PMID:  9201838     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Thirty-three skeletally immature patients younger than 12 years of age and having posterior arthrodesis and evidence of solid posterior fusion without "adding on" were retrospectively reviewed. All patients had a minimum of 5 years of follow-up.
OBJECTIVES: To ascertain factors associated with crankshaft and to determine how accurate a marker the triradiate cartilage was.
SUMMARY OF DATA: All patients had Risser Stage 0 curves and all of the girls were premenarchal preoperatively. The average age was 9 years 3 months (range, 2 years-11 years 11 months). Preoperative diagnoses consisted of 14 idiopathic, 11 congenital, five dysplastic, and three neuromuscular etiologies.
METHODS: Preoperatively, within 3 months after surgery, and at 2-year, 5-year, and final postoperative follow-up, the following radiographic parameters were reviewed: coronal Cobb, apical vertebral rotation, apical vertebral translation, rib vertebral angle difference, and trunkshift.
RESULTS: The triradiate cartilage was open in 24 patients at the time of operation. Of those 24, only nine (37.5%) had documented proof of crankshaft. Patients with closed triradiate cartilage had no significant postoperative increase in radiographic parameters (0 of 9). The subgroup of patients with idiopathic scoliosis had an average age of 11 years 3 months (range, 9 years 2 months-11 years 11 months). Five of 14 patients had an open triradiate cartilage. All were followed up to skeletal maturity. None had significant progression in postoperative radiographic parameters.
CONCLUSION: This study did not find an open triradiate cartilage to be an absolute prognostic indicator for the occurrence of crankshaft. Additional refinement of markers of maturity are needed to determine who requires anterior arthrodesis.
C L Hamill; K H Bridwell; L G Lenke; M P Chapman; C Baldus; K Blanke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  22     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-08-12     Completed Date:  1997-08-12     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1343-51     Citation Subset:  IM    
St. Louis Children's Hospital, Missouri, USA.
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MeSH Terms
Cartilage, Articular / growth & development,  radiography
Disease Progression
Follow-Up Studies
Postoperative Complications / epidemiology*,  physiopathology,  radiography
Retrospective Studies
Risk Factors
Scoliosis / physiopathology,  radiography,  surgery*
Spinal Fusion*
Spine / growth & development
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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