Mansour Adam, Chowdhury Allison, Englert E Graham, Kadado Allen
From the Department of Orthopedics, Nationwide Children's Hospital (Dr. Mansour, Dr. Englert, Dr. Kadado); and the Department of Orthopedics, The Ohio State University, Columbus, OH (Dr. Chowdhury).
J Am Acad Orthop Surg Glob Res Rev. 2025 Jun 11;9(6). doi: 10.5435/JAAOSGlobal-D-24-00343. eCollection 2025 Jun 1.
A healthy 15-year-old male athlete presented with upper thoracic congenital kyphoscoliosis, causing notable pain and limiting participation in competitive sports. In addition to mid and low back pain related to sagittal profile, the patient also expressed concerns regarding shape of his back from the compensatory thoracolumbar lordosis relative to his desired physical activities. Imaging demonstrated an abnormal fusion segment from T4-T8 with hemivertebrae at T6 and T7. After failing conservative management, the patient underwent T2-L2 posterior spinal fusion with posterior column osteotomies, successfully restoring sagittal alignment and allowing a return to high-impact sports. Unfavorable symptoms associated with abnormal sagittal spinal alignment should be considered even in a stable, nonprogressive deformity. Sagittal correction with posterior spinal instrumented fusion can effectively restore sagittal posture and function in athletes with congenital kyphoscoliosis associated with a sweeping and symptomatic thoracolumbar lordosis, altering the natural history of the deformity and improving quality of life.
一名健康的15岁男性运动员因上胸椎先天性脊柱后凸侧弯前来就诊，该病导致明显疼痛并限制了他参与竞技体育活动。除了与矢状面轮廓相关的中背部和下背部疼痛外，患者还对相对于其期望的体育活动而言，因代偿性胸腰段脊柱前凸导致的背部形态表示担忧。影像学检查显示T4 - T8节段异常融合，T6和T7有半椎体。在保守治疗失败后，患者接受了T2 - L2后路脊柱融合术及后柱截骨术，成功恢复了矢状面排列，并得以重返高强度运动。即使在稳定、非进行性畸形的情况下，也应考虑与脊柱矢状面排列异常相关的不良症状。后路脊柱器械融合矢状面矫正能够有效恢复先天性脊柱后凸侧弯合并明显症状性胸腰段脊柱前凸的运动员的矢状面姿势和功能，改变畸形的自然病程，提高生活质量。
