Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota.
Oper Neurosurg (Hagerstown). 2018 Sep 1;15(3):278-284. doi: 10.1093/ons/opx221.
Surgical treatment of severe cervicothoracic kyphotic deformity may require the use of 3-column osteotomies such as the pedicle subtraction osteotomy and vertebral column resection (VCR), or VCR with anterior longitudinal ligament resection. Such procedures are extensive and are associated with high intra- and perioperative morbidity, in part, due to the need for risky reduction maneuvers.
To describe a novel technique utilizing a laterally placed articulating hinge to facilitate kyphotic deformity correction of the cervicothoracic spine.
A patient with severe chin-on-chest deformity of the cervicothoracic spine presented for evaluation and a 2-stage VCR with anterior longitudinal ligament resection was planned. To reduce the risk of intraoperative neurological injury and for increased control during reduction maneuvers, lateral instrumentation was placed through the chest wall resection above and below the level of VCR, which was adjoined with an articulating hinge rod apparatus.
Satisfactory reduction of the kyphosis was achieved utilizing the hinge rod apparatus for controlled deformity correction. The patient remained neurologically intact following this procedure with improvement in their spinal alignment.
We present a novel technique utilizing a lateral hinge rod apparatus for efficient, controlled correction of severe kyphotic deformity.
严重颈胸脊柱后凸畸形的手术治疗可能需要使用三柱截骨术，如椎弓根切除截骨术和脊柱截骨术（VCR），或 VCR 联合前纵韧带切除术。这些手术广泛，与较高的围手术期发病率有关，部分原因是需要进行有风险的复位操作。
描述一种利用侧向铰接铰链来辅助颈胸脊柱后凸畸形矫正的新技术。
一名严重的颈胸脊柱下颌碰头畸形患者前来就诊，计划进行两阶段 VCR 联合前纵韧带切除术。为了降低术中神经损伤的风险并增加复位操作的控制，通过 VCR 上下的胸壁切除部位放置侧向器械，与铰接铰链杆装置相连。
利用铰链杆装置进行了满意的后凸矫正，实现了对畸形的有效控制。该患者术后神经功能完整，脊柱排列得到改善。
我们提出了一种利用侧向铰链杆装置进行高效、可控的严重后凸畸形矫正的新技术。
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