Harrington Rod Decades Later Charlotte NC | Back Pain, Flatback, Revision Data | Clear Life Scoliosis

By Dr. Justin Dick, DC (ORCID 0009-0001-2794-2159) · Clear Life Scoliosis and Chiropractic Center, Charlotte, NC · Published November 11, 2026

Harrington rods were the standard scoliosis surgery from the 1960s into the 1990s, and many adults now in their 40s to 70s still have them. A 2024 meta-analysis by Barile and colleagues pooled 11 studies of 644 patients followed 10.8 to 51.7 years: the main curve went from 60.6° before surgery to 38.3° at last follow-up, about 9.5° of correction was lost over time, 42 percent had additional spine surgery, and low back pain was more common than in controls, while overall quality of life and function were comparable to people without scoliosis.

I am Dr. Justin Dick, DC, at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. Adults with old Harrington fusions come to me with low back pain, forward lean, or worsening posture. This post covers what the long-term data show and what their options are.

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Why Harrington Rods Behave Differently

A Harrington rod straightened the curve by distraction, lengthening the concave side. It corrected the side-to-side curve but did not derotate vertebrae and tended to flatten the low back. Barile found flattened sagittal alignment and limited rib hump correction. When the fusion extended into the lower lumbar spine, the loss of lumbar curve could leave the patient leaning forward, which is flat back syndrome. My post on flat back syndrome covers that problem.

Long-Term Outcomes

Sulovari and colleagues contacted 318 patients fused between 1961 and 1978, at a minimum of 40 years. Patient-reported outcomes were not associated with how high the fusion went, and those who later needed neck surgery reported more pain interference. Brumat and colleagues followed 12 women for a mean of 11 years after their Harrington rods were removed and found no significant radiographic progression. These results are reassuring for many, but the 42 percent additional surgery rate in the meta-analysis is not small.

Revision Surgery

Stephan and colleagues reported 26 adults (mean age 55.5) revised after Harrington constructs. Fused levels increased from about 10 to 16, alignment improved, and Oswestry disability fell from 35.6 to 25.4. Complications occurred in 76.9 percent, most often lumbar nerve root weakness, which recovered in all but one patient, and 19.2 percent needed further revision. Revision helps many patients and is a major operation.

Nonsurgical Options

Boucher and colleagues described a woman fused with a Harrington rod at 24 whose rod was removed for infection and who later developed 80° of thoracic kyphosis; 28 months of Schroth-based physiotherapy and part-time bracing reduced kyphosis to 45° and improved lung capacity. That is one case and cannot be generalized, but it shows that conservative care is not irrelevant after fusion. Care below or above a solid fusion focuses on the mobile segments, hips, and trunk endurance. My post on care after spinal fusion covers technique limits.

How Dr. Justin Dick, DC Evaluates Old Fusions at Clear Life

At our Charlotte office, adults with Harrington rods get standing full-spine radiographs to measure sagittal balance, the segments below the fusion, and hardware. Care is adapted around the fusion, and patients with progressive imbalance or neurological signs are referred to a revision surgeon.

Comparison

Research and Evidence

Evidence tiering: Barile is a meta-analysis of observational studies; Sulovari, Stephan, and Brumat are retrospective cohorts; Boucher is a single case report. No randomized comparison of revision and nonsurgical care exists that I could find.

My published work includes older adults with prior lumbar surgery: the refractory lumbar pain case report, Refractory Lumbar Pain Following Motor Vehicle Collision in a Geriatric Patient With Prior Lumbar Surgery (Cureus, 2026, PMID 41694169), one geriatric patient.

References

1. Barile F, Ruffilli A, Morandi Guaitoli M, et al. Long-term follow-up of adolescent idiopathic scoliosis surgery with Harrington instrumentations: a systematic review and meta-analysis. Musculoskelet Surg. 109(1):17-31 (epub 2024). doi:10.1007/s12306-024-00836-y
2. Sulovari A, Omar AM, Section JA, et al. Correlation of upper instrumented vertebrae and future cervical spine surgery to patient-reported outcomes in adolescent idiopathic scoliosis treated with Harrington rod instrumentation: a minimum 40-year follow-up. Clin Spine Surg. 2025. doi:10.1097/BSD.0000000000001913
3. Brumat P, Mohar J, Čeleš D, et al. No significant radiological signs of adult spinal deformity progression after a mean of 11 years of follow-up following Harrington rod instrumentation removal and watchful waiting. Healthcare (Basel). 2023;11(8):1149. doi:10.3390/healthcare11081149
4. Stephan SR, Hassan FM, Mikhail C, et al. Revision of Harrington rod constructs: a single-center's experience with this homogenous adult spinal deformity population at a minimum 2-year follow-up. Spine Deform. 2024;12(5):1441-1452. doi:10.1007/s43390-024-00867-2
5. Boucher J, Lebel A, Nguyen DN, et al. Improvement after hardware removal in post-fusion adult AIS: a unique 35-year case study using Schroth-based physiotherapy and bracing. Healthcare (Basel). 14(1):43 (epub 2025). doi:10.3390/healthcare14010043
6. Dick JM. Refractory lumbar pain following motor vehicle collision in a geriatric patient with prior lumbar surgery: clinical resolution after multimodal conservative spinal structural rehabilitation. Cureus. 2026;18(2):e103540. doi:10.7759/cureus.103540

Frequently Asked Questions

Service Area

Clear Life Scoliosis and Chiropractic Center sees patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, Fort Mill SC. Families from across the Charlotte region and the South Carolina border communities come to the Rachel Freeman Way office for radiographic scoliosis evaluation with Dr. Justin Dick, DC.

Related Pages

• Care After Spinal Fusion
• Scoliosis Rods Long Term
• Flat Back Syndrome
• Scoliosis Care After Spinal Fusion
• Bending After Scoliosis Surgery
• Scoliosis Treatment for Adults
• Scoliosis Surgery Risks and Outcomes
• Scoliosis Second Opinion
• Scoliosis Care Program
• Dr. Justin Dick, DC Research

Schedule an Evaluation in Charlotte

If you have a Harrington rod and your posture or pain is changing, standing films show what is happening below the fusion. Dr. Justin Dick, DC can review them at our Charlotte office.

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