The History of Harrington’s Rod and the Development of Longsegment Spine Surgery Constructs

Amadi Bharav^*
*Correspondence: Amadi Bharav, Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USA, Email:

Introduction

The field of spine surgery has evolved remarkably over the past century, with significant advancements in techniques and instrumentation that have dramatically improved patient outcomes. One of the most groundbreaking innovations in the history of spinal surgery was the introduction of Harrington’s rod in the 1950s, developed by Dr. Paul Harrington. His invention revolutionized the treatment of scoliosis and laid the foundation for long-segment spine surgery constructs. Before the advent of modern instrumentation, spine deformities, particularly scoliosis, were treated through non-surgical methods or cumbersome techniques that yielded suboptimal outcomes. Harrington's rod not only transformed the way spine deformities were treated but also set the stage for the development of sophisticated spinal fixation systems used today. This article explores the history of Harrington's rod, its impact on spine surgery, and the evolution of long-segment spine surgery constructs, highlighting the significant milestones in this critical field. Scoliosis, a condition characterized by an abnormal lateral curvature of the spine, has plagued humanity for centuries. Its causes are multifactorial, including congenital, idiopathic, and neuromuscular origins. Before the development of surgical interventions, treatments were largely based on external bracing, casting, and traction. These non-surgical methods provided limited correction of deformities and were often uncomfortable for patients. Furthermore, without proper stabilization, any correction achieved with bracing or traction was temporary, as the spine often returned to its deformed state once the support was removed. In the early 20th century, surgical attempts to correct scoliosis were made, but they were often fraught with complications, including high rates of infection, inadequate correction, and the need for prolonged bed rest. Spinal fusion without internal fixation was performed, but these procedures were prone to failure, as the absence of internal support led to the collapse of the spine before the fusion could take hold. There was a pressing need for a solution that could provide stable correction of spinal deformities, allowing for proper fusion and reducing the reliance on external bracing and prolonged immobilization [1-3].

Description

His goal was to create an internal device that would correct the curvature of the spine and maintain that correction while the spine fused. Over the next decade, Harrington developed a stainless steel rod system that could be implanted into the spine to stabilize and straighten it. Harrington’s rod consisted of a long stainless steel rod placed along the concave side of the spinal curve. The rod was attached to the spine using hooks and distraction components, which allowed the surgeon to apply corrective force to straighten the spine. The device provided internal fixation, which maintained the spinal alignment while the vertebrae fused over time. This internal support allowed for better correction of scoliosis and reduced the need for external bracing post-operatively. In 1960, Harrington published his initial results, showing significant success in correcting scoliosis with his rod system. His approach quickly gained widespread acceptance, revolutionizing the treatment of scoliosis and other spinal deformities. For the first time, surgeons had a reliable method of maintaining spinal alignment after surgery, reducing complications and improving long-term outcomes. Despite its groundbreaking nature, Harrington’s rod was not without limitations. The device provided excellent correction of the spinal curve in the coronal plane (side-to-side), but it did not address the rotational component of scoliosis. Over time, patients with Harrington rods were prone to developing flat-back syndrome, a condition where the natural curvature of the spine in the sagittal plane was lost, leading to poor posture and chronic pain. Additionally, Harrington’s rod did not allow for segmental fixation, meaning that the force applied to correct the spine was often concentrated over a few vertebrae, leading to stress on the adjacent segments [4,5].

Conclusion

Harrington’s rod also set the stage for advancements in other areas of spinal surgery, including the treatment of degenerative spine conditions, trauma, and tumor resection. The techniques and principles developed in the treatment of scoliosis have been adapted to a wide range of spinal pathologies, improving the lives of countless patients around the world. The invention of Harrington’s rod was a pivotal moment in the history of spine surgery. It revolutionized the treatment of scoliosis and paved the way for the development of more sophisticated spinal fixation systems. . The limitations of Harrington’s rod spurred further innovations in spinal instrumentation, leading to the development of more advanced long-segment spine surgery constructs. The goal was to improve upon the foundation that Harrington had laid, addressing the shortcomings of his system while maintaining its benefits. Over the following decades, several key advancements were made. One of the major developments following Harrington’s rod was the introduction of segmental fixation systems. These systems allowed for fixation at multiple levels of the spine, distributing corrective forces more evenly and reducing stress on individual segments. Segmental fixation provided greater control over spinal alignment in all three planes: coronal, sagittal, and axial

Acknowledgement

None.

Conflict of Interest

None.

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