The crankshaft phenomenon

J. Dubousset, J. A. Herring, H. Shufflebarger

Research output: Contribution to journalArticlepeer-review

257 Scopus citations


We reviewed 40 spinal fusions done prior to Risser stage I for idiopathic and paralytic scoliosis to evaluate postoperative curve progression. The 39 patients who had posterior fusion alone had progressive angulation and rotation of the spine over the postoperative follow-up period. The more immature the patient, the greater the resultant progression. This progression is an inevitable consequence of continued anterior spinal growth in the presence of a posterior fusion, and occurs without pseudarthrosis or hardware failure. Younger patients may require anterior and posterior fusion to achieve stable correction.

Original languageEnglish (US)
Pages (from-to)541-550
Number of pages10
JournalJournal of Pediatric Orthopaedics
Issue number5
StatePublished - Jan 1 1989


  • Posterior fusion
  • Postoperative curve progression
  • Risser stage I
  • Scoliosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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