Preview

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika)

Advanced search

Surgical treatment of severe congenital kyphosis in an adult patient: rare clinical observation and a brief literature review

https://doi.org/10.14531/2018.4.21-26

Abstract

The paper presents a clinical case of surgical treatment of an adult patient with severe rigid congenital kyphosis developed due to multiple anomalies in the thoracolumbar spine. Surgical intervention included vertebral column resection (VCR) and the deformity correction using segmental third-generation instrumentation with transpedicular fixation. The VCR made it possible to correct the relationship between vertebrae in the anomaly zone, to improve the shape of the spinal canal and increase its volume, and to achieve apparent mobility of the spine at the apex of the kyphosis. Preservation of the anterosuperior portion of the body of the resected vertebra allowed avoiding anterior mesh cage use to support and reconstruct the anterior supporting column of the resected segment. This enabled performing necessary correction of severe kyphotic deformity, reduced the risk of neurological complications, and favored the formation of solid bone block in the long-term period after surgery.

About the Authors

V. V. Novikov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation

DMSc, senior researcher, head of Research Department of Children and Adolescent Spine Surgery

 Frunze str., 17, Novosibirsk, 630091



A. Yu. Sergunin
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation

junior researcher of Research Department of Children and Adolescent Spine Surgery

 Frunze str., 17, Novosibirsk, 630091



V. V. Belozerov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation

junior researcher of Research Department of Children and Adolescent Spine Surgery

Frunze str., 17, Novosibirsk, 630091,



M. N. Lebedeva
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation

DMSc, head of Research Department of Anesthesiology and reanimatology

Frunze str., 17, Novosibirsk, 630091



A. S. Vasyura
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation

MD, PhD, senior researcher of Department of Children and Adolescent Spine Surgery

 Frunze str., 17, Novosibirsk, 630091



M. V. Mikhaylovskiy
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation

DMSc, Prof., chief researcher of Department of Children and Adolescent Spine Surgery

Frunze str., 17, Novosibirsk, 630091



References

1. Ульрих Э.В., Мушкин А.Ю., Лонштейн Д.Е., Винтер Р.Б. «Чистые» врожденные кифозы: анатомо-лучевая классификация и клинические особенности // Хирургия позвоночника. 2004. № 1. С. 78–84. [Ulrikh EV, Mushkin AY, Lonstein JE, Winter RB. The «pure» congenital kyphosis: anatomicradiological classification and clinical peculiarities. Hir. Pozvonoc. 2004;(1):78–84. In Russian].

2. Михайловский М.В., Новиков В.В., Удалова И.Г. Радикальные дорсальные вмешательства в лечении кифотических деформаций // Вестник травматологии и ортопедии им. Н.Н. Приорова. 2015. № 2. С. 66–75. [Mikhailovskiy MV, Novikov VV, Udalova IG. Radical dorsal interventions in treatment of kyphotic deformities (literature review). Vestnik travmatologii i ortopedii imeni N.N. Priorova. 2015;(2):66–75. In Russian].

3. Kim KT, Park KJ, Lee JH. Osteotomy of the spine to correct the spinal deformity. Asian Spine J. 2009;3:113–123. DOI: 10.4184/asj.2009.3.2.113.

4. MacLennan A. Scoliosis. Br Med J. 1922;2:865–866.

5. Bradford DS, Boachie-Adjei O. One-stage anterior and posterior hemivertebral resection and arthrodesis for congenital scoliosis. J Bone Joint Surg Am. 1990;72:536–540.

6. Boachie-Adjei O, Bradford DS. Vertebral column resection and arthrodesis for complex spinal deformities. J Spinal Disord. 1991;4:193–202.

7. Ленке Л., Боши-Аджей О., Ванг Я. Остеотомии позвоночника. М.; СПб., 2016. [Lenke L, Boachie-Adjei O, Wang Y. Spinal Osteotomy. Transl. from English. Moscow; St. Petersburg, 2016. In Russian].

8. Luque ER. Vertebral column transposition. Orthop Trans. 1983;7:29.

9. Bradford DS. Vertebral column resection. Orthop Trans. 1987;11:502.

10. Suk SI, Kim JH, Kim WJ, Lee SM, Chung ER, Nah KH. Posterior vertebral column resection for severe spinal deformities. Spine. 2002;27:2374–2382.

11. Bradford DS, Tribus CB. Vertebral column resection for the treatment of rigid coronal decompensation. Spine. 1997;22:1590–1599. DOI: 10.1097/00007632-199707150-00013.

12. Suk SI, Kim WJ, Lee SM, Kim JH, Chung ER. Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine. 2001;26:2049–2057. DOI: 10.1097/00007632-200109150-00022.


Review

For citations:


Novikov V.V., Sergunin A.Yu., Belozerov V.V., Lebedeva M.N., Vasyura A.S., Mikhaylovskiy M.V. Surgical treatment of severe congenital kyphosis in an adult patient: rare clinical observation and a brief literature review. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2018;15(4):21-26. https://doi.org/10.14531/2018.4.21-26



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1810-8997 (Print)
ISSN 2313-1497 (Online)