Mirzanli Cuneyd, Ozturk Cagatay, Karatoprak Omer, Aydogan Mehmet, Tezer Mehmet, Hamzaoglu Azmi
Orthopaedic and Traumatology Department, Istanbul Spine Center, Florence Nightingale Hospital, Abide-I Hurriyet cd. No: 290 Sisli, Istanbul 34360, Turkey.
Spine J. 2008 Jul-Aug;8(4):683-6. doi: 10.1016/j.spinee.2006.12.008. Epub 2007 Mar 5.
Congenital kyphosis or kyphoscoliosis is an uncommon deformity that usually is progressive without surgical intervention. In the lately diagnosed or neglected cases of congenital kyphoscoliosis, the patients may come with shoulder-trunk imbalance anomalies, severe deformity in coronal and sagittal plane, rib cage deformities, pelvic tilt, presence of intramedullary anomalies, neurological deficit, and difficulty in walking and cardiopulmonary problems.
To present a technical note related with double-segment total vertebrectomy for the surgical treatment of a patient who had neglected congenital kyphoscoliosis in lumbar spine.
Case report.
A 19-year-old girl had submitted to our center with complaints of deformity and pain in her back. Her physical examination revealed scoliosis and gibbosity in lumbar region. Her neurological examination was normal. In the radiological examination, X-ray films showed 42 degrees lumbar scoliosis in frontal plane and 35 degrees kyphotic curvature in the sagittal plane.
Three-staged (posterior-anterior-posterior) surgery in the same session (same anesthesia) was performed.
Total or partial vertebrectomy on the apex of the deformity and the adjacent vertebral bodies along with anterior stabilization by means of a cylindrical cage combined in one operative procedure preceded by temporary posterior instrumentation and followed by posterior instrumentation and fusion may be preferred for the treatment of congenital kyphoscoliosis in neglected cases to provide spinal cord decompression.
先天性脊柱后凸或脊柱侧后凸是一种罕见的畸形，通常在不进行手术干预的情况下会进展。在最近诊断或被忽视的先天性脊柱侧后凸病例中，患者可能伴有肩-躯干不平衡异常、冠状面和矢状面严重畸形、胸廓畸形、骨盆倾斜、存在髓内异常、神经功能缺损以及行走困难和心肺问题。
介绍一篇与双节段全椎体切除术相关的技术笔记，用于手术治疗一名被忽视的腰椎先天性脊柱侧后凸患者。
病例报告。
一名19岁女孩因背部畸形和疼痛前来我院就诊。体格检查发现其腰椎区域有脊柱侧凸和驼背。神经学检查正常。影像学检查中，X线片显示其额状面腰椎侧凸42度，矢状面后凸曲度35度。
在同一手术过程（相同麻醉）中进行了三期（后-前-后）手术。
对于被忽视的先天性脊柱侧后凸病例，在一期手术中，先进行临时后路器械固定，然后在畸形顶点及相邻椎体进行全椎体或部分椎体切除，并通过圆柱形椎间融合器进行前路稳定，最后进行后路器械固定和融合，可能更有利于治疗，以实现脊髓减压。
