Diebo Bassel G, Balmaceno-Criss Mariah, Daher Mohammad, Daniels Alan H
Department of Orthopaedic Surgery, Brown University, Providence, RI, United States.
Spine surgery division, University Orthopedics Inc, 1 Kettle Point Ave, East Providence, RI, 02914, United States.
N Am Spine Soc J. 2023 Jul 28;15:100247. doi: 10.1016/j.xnsj.2023.100247. eCollection 2023 Sep.
Severe positive sagittal malalignment can potentially lead to shortening and contracture of the psoas and joint capsule in a flexed spinopelvic position. The utilization of bilateral psoas release to supplement sagittal spinal deformity correction in the same hospitalization was not reported in the literature.
A 66-year-old patient presented with a 5-year history of severe global spinal deformity (sagittal vertical axis 220 mm, 60° spinopelvic mismatch) that did not improve on supine radiographs, and a modified Thomas test with more than 30° flexion contracture of bilateral hips. A 3-stage operation utilizing posterior spinal column osteotomies, anterior lumbar interbody fusion, and bilateral psoas releases was performed.
Her postoperative alignment significantly improved and she was pleased with her new posture and the ability to stand up straight.
This report is the first to demonstrate safe and substantial correction of severe spinal deformities associated with bilateral hip flexion contracture in 1 hospitalization.
严重的矢状面畸形可能导致腰大肌和关节囊在脊柱骨盆屈曲位时缩短和挛缩。文献中未报道在同一住院期间利用双侧腰大肌松解来辅助矢状面脊柱畸形矫正。
一名66岁患者，有5年严重的全身性脊柱畸形病史（矢状垂直轴220mm，脊柱骨盆失配60°），仰卧位X线片显示无改善，改良托马斯试验显示双侧髋关节屈曲挛缩超过30°。进行了三阶段手术，包括后路脊柱截骨术、前路腰椎椎间融合术和双侧腰大肌松解术。
她术后的对线情况显著改善，对新姿势和能够站直感到满意。
本报告首次证明了在一次住院期间安全且显著地矫正与双侧髋关节屈曲挛缩相关的严重脊柱畸形。
