Prediction of the crankshaft phenomenon by peak height velocity

James Sanders, David G. Little, B. Stephens Richards

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Study Design. Retrospective review. Objectives. To evaluate the relation of the peak height velocity with the occurrence of the crankshaft phenomenon after posterior arthrodesis and instrumentation in idiopathic scoliosis. Summary of Background Data. Although patients with closed triradiate cartilages are unlikely to exhibit the crankshaft phenomenon after a posterior spinal fusion and instrumentation, open triradiate cartilages do not necessitate that crankshafting will occur. Less than half of patients with idiopathic scoliosis and open triradiate cartilages will exhibit the crankshaft phenomenon. Methods. The authors reviewed 43 patients with idiopathic scoliosis who were Risser 0 at the time of posterior spinal fusion. Twenty-three patients had open triradiate cartilages and twenty had closed. The timing of peak height velocity was identified. Results. All patients with closed triradiate cartilages were beyond their peak height velocity at the time of surgery. Among those with open triradiate cartilages, 8 were operated on before or during their peak and 15 were operated on afterward. All patients fused before or during the peak crankshafted. Two of the fifteen patients fused after the peak crankshafted. In one, it was low grade. In the other, it appears that the fusion blunted the peak height velocity to a point at which it was unidentifiable. Conclusions. In patients with open triradiate cartilages, surgery performed before or during the peak height velocity is a strong predictor of the crankshaft phenomenon, and later surgery is a strong negative predictor of the crankshafting (P = 0.000009). Isolated posterior fusion before the height velocity decelerates results in the crankshaft phenomenon, whereas fusion during the deceleration phase does not.

Original languageEnglish (US)
Pages (from-to)1352-1357
Number of pages6
JournalSpine
Volume22
Issue number12
DOIs
StatePublished - Jun 15 1997

Fingerprint

Cartilage
Scoliosis
Spinal Fusion
Deceleration
Arthrodesis

Keywords

  • Crankshaft
  • Peak height velocity
  • Scoliosis
  • Spine growth

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Prediction of the crankshaft phenomenon by peak height velocity. / Sanders, James; Little, David G.; Stephens Richards, B.

In: Spine, Vol. 22, No. 12, 15.06.1997, p. 1352-1357.

Research output: Contribution to journalArticle

Sanders, James ; Little, David G. ; Stephens Richards, B. / Prediction of the crankshaft phenomenon by peak height velocity. In: Spine. 1997 ; Vol. 22, No. 12. pp. 1352-1357.
@article{b693104b0f884f96b0ff267fc762cb13,
title = "Prediction of the crankshaft phenomenon by peak height velocity",
abstract = "Study Design. Retrospective review. Objectives. To evaluate the relation of the peak height velocity with the occurrence of the crankshaft phenomenon after posterior arthrodesis and instrumentation in idiopathic scoliosis. Summary of Background Data. Although patients with closed triradiate cartilages are unlikely to exhibit the crankshaft phenomenon after a posterior spinal fusion and instrumentation, open triradiate cartilages do not necessitate that crankshafting will occur. Less than half of patients with idiopathic scoliosis and open triradiate cartilages will exhibit the crankshaft phenomenon. Methods. The authors reviewed 43 patients with idiopathic scoliosis who were Risser 0 at the time of posterior spinal fusion. Twenty-three patients had open triradiate cartilages and twenty had closed. The timing of peak height velocity was identified. Results. All patients with closed triradiate cartilages were beyond their peak height velocity at the time of surgery. Among those with open triradiate cartilages, 8 were operated on before or during their peak and 15 were operated on afterward. All patients fused before or during the peak crankshafted. Two of the fifteen patients fused after the peak crankshafted. In one, it was low grade. In the other, it appears that the fusion blunted the peak height velocity to a point at which it was unidentifiable. Conclusions. In patients with open triradiate cartilages, surgery performed before or during the peak height velocity is a strong predictor of the crankshaft phenomenon, and later surgery is a strong negative predictor of the crankshafting (P = 0.000009). Isolated posterior fusion before the height velocity decelerates results in the crankshaft phenomenon, whereas fusion during the deceleration phase does not.",
keywords = "Crankshaft, Peak height velocity, Scoliosis, Spine growth",
author = "James Sanders and Little, {David G.} and {Stephens Richards}, B.",
year = "1997",
month = "6",
day = "15",
doi = "10.1097/00007632-199706150-00013",
language = "English (US)",
volume = "22",
pages = "1352--1357",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Prediction of the crankshaft phenomenon by peak height velocity

AU - Sanders, James

AU - Little, David G.

AU - Stephens Richards, B.

PY - 1997/6/15

Y1 - 1997/6/15

N2 - Study Design. Retrospective review. Objectives. To evaluate the relation of the peak height velocity with the occurrence of the crankshaft phenomenon after posterior arthrodesis and instrumentation in idiopathic scoliosis. Summary of Background Data. Although patients with closed triradiate cartilages are unlikely to exhibit the crankshaft phenomenon after a posterior spinal fusion and instrumentation, open triradiate cartilages do not necessitate that crankshafting will occur. Less than half of patients with idiopathic scoliosis and open triradiate cartilages will exhibit the crankshaft phenomenon. Methods. The authors reviewed 43 patients with idiopathic scoliosis who were Risser 0 at the time of posterior spinal fusion. Twenty-three patients had open triradiate cartilages and twenty had closed. The timing of peak height velocity was identified. Results. All patients with closed triradiate cartilages were beyond their peak height velocity at the time of surgery. Among those with open triradiate cartilages, 8 were operated on before or during their peak and 15 were operated on afterward. All patients fused before or during the peak crankshafted. Two of the fifteen patients fused after the peak crankshafted. In one, it was low grade. In the other, it appears that the fusion blunted the peak height velocity to a point at which it was unidentifiable. Conclusions. In patients with open triradiate cartilages, surgery performed before or during the peak height velocity is a strong predictor of the crankshaft phenomenon, and later surgery is a strong negative predictor of the crankshafting (P = 0.000009). Isolated posterior fusion before the height velocity decelerates results in the crankshaft phenomenon, whereas fusion during the deceleration phase does not.

AB - Study Design. Retrospective review. Objectives. To evaluate the relation of the peak height velocity with the occurrence of the crankshaft phenomenon after posterior arthrodesis and instrumentation in idiopathic scoliosis. Summary of Background Data. Although patients with closed triradiate cartilages are unlikely to exhibit the crankshaft phenomenon after a posterior spinal fusion and instrumentation, open triradiate cartilages do not necessitate that crankshafting will occur. Less than half of patients with idiopathic scoliosis and open triradiate cartilages will exhibit the crankshaft phenomenon. Methods. The authors reviewed 43 patients with idiopathic scoliosis who were Risser 0 at the time of posterior spinal fusion. Twenty-three patients had open triradiate cartilages and twenty had closed. The timing of peak height velocity was identified. Results. All patients with closed triradiate cartilages were beyond their peak height velocity at the time of surgery. Among those with open triradiate cartilages, 8 were operated on before or during their peak and 15 were operated on afterward. All patients fused before or during the peak crankshafted. Two of the fifteen patients fused after the peak crankshafted. In one, it was low grade. In the other, it appears that the fusion blunted the peak height velocity to a point at which it was unidentifiable. Conclusions. In patients with open triradiate cartilages, surgery performed before or during the peak height velocity is a strong predictor of the crankshaft phenomenon, and later surgery is a strong negative predictor of the crankshafting (P = 0.000009). Isolated posterior fusion before the height velocity decelerates results in the crankshaft phenomenon, whereas fusion during the deceleration phase does not.

KW - Crankshaft

KW - Peak height velocity

KW - Scoliosis

KW - Spine growth

UR - http://www.scopus.com/inward/record.url?scp=0030920128&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030920128&partnerID=8YFLogxK

U2 - 10.1097/00007632-199706150-00013

DO - 10.1097/00007632-199706150-00013

M3 - Article

C2 - 9201839

AN - SCOPUS:0030920128

VL - 22

SP - 1352

EP - 1357

JO - Spine

JF - Spine

SN - 0362-2436

IS - 12

ER -