Bourghli Anouar, Boissiere Louis, Konbaz Faisal, Roscop Cecile, Almusrea Khaled, Obeid Ibrahim
Spine Surgery Department, King Faisal Specialist Hospital and Research Center, P. O. Box 3354, 11211, Riyadh, Saudi Arabia.
Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France.
Spine Deform. 2025 May 25. doi: 10.1007/s43390-025-01108-w.
To describe the technique of closing-opening vertebral column resection (COVCR) in an adult patient with severe thoracolumbar kyphosis secondary to two adjacent posterior hemivertebrae.
COVCR is a rare technique as it can only be applied in a very specific deformity configuration.
We report the case of a 26-year-old male who has been complaining of middle and low back pain for over 10 years with difficulties when walking for long distances. Full spine anteroposterior and lateral X-rays revealed a severe thoracolumbar kyphosis with an angulation of 95° between T10 and L1. CT scan confirmed the presence of two adjacent posterior hemivertebrae at the level of T11 and T12. MRI did not show any spinal cord anomalies.
The patient underwent a posterior resection of T11 and T12 vertebrae with instrumentation from T7 to L4. Through the use of a side-to-side domino connector, closing of the middle column and opening of the anterior column were achieved demonstrating a COVCR. No cage was inserted. Thoracolumbar kyphosis was corrected to 25°. He could walk on day 2 with a satisfactory clinical and radiological result at 2 years.
This is the first paper to describe the true COVCR as a surgical technique for the management of congenital thoracolumbar kyphosis. Such variation of VCR may be applied in the presence of a posterior hemivertebra where the configuration enables opening of the anterior column and closing of the middle column.
描述在一名因两个相邻后半椎体继发严重胸腰段后凸畸形的成年患者中进行开合式脊柱切除术（COVCR）的技术。
COVCR是一种罕见的技术，因为它仅适用于非常特殊的畸形构型。
我们报告了一例26岁男性患者，他抱怨腰背部疼痛超过10年，长途行走困难。全脊柱正侧位X线片显示严重的胸腰段后凸畸形，T10和L1之间成角95°。CT扫描证实T11和T12水平存在两个相邻的后半椎体。MRI未显示任何脊髓异常。
患者接受了T11和T12椎体后路切除术，并进行了从T7至L4的内固定。通过使用左右多米诺连接器，实现了中柱闭合和前柱打开，展示了COVCR。未植入椎间融合器。胸腰段后凸畸形矫正至25°。患者术后第2天即可行走，2年时临床和影像学结果均令人满意。
本文首次将真正的COVCR描述为一种治疗先天性胸腰段后凸畸形的手术技术。这种VCR变体可应用于存在后半椎体且构型允许前柱打开和中柱闭合的情况。
