Christof Birkenmaier1, Melvin D'Anastasi2,3, Bernd Wegener2, Carolin Melcher2. 1. Department of Orthopaedics, Physical Medicine and Rehabilitation, Grosshadern Medical Center, Ludwig-Maximilian-University, 81377, Munich, Germany. Christof.birkenmaier@med.uni-muenchen.de. 2. Department of Orthopaedics, Physical Medicine and Rehabilitation, Grosshadern Medical Center, Ludwig-Maximilian-University, 81377, Munich, Germany. 3. Medical Imaging Department, Mater Dei Hospital, Marchioninistrasse 15, Tal-Qroqq, Msida, MSD 2090, Malta.
Abstract
BACKGROUND: We describe a case of severe and progressive lumbar hyperlordosis (160°) in a 28-year-old female university student with cerebral palsy. Her main complaints were abdominal wall pain and increasing inability to sit in her custom wheelchair. METHOD: When deciding on our opinion about the most promising treatment strategy, we contemplated slow continued correction by means of percutaneously expandable magnetic rods (MAGEC) after the index surgery as a key component of a satisfactory correction in this severe and rigid curve. After an initial radical release and partial correction, a release and correction procedure was required for the bilateral hip flexion contracture. A final in situ posterior fusion was performed as a second spinal procedure, once the desired final correction at 66° of lumbar lordosis was achieved. RESULT: Three years after the completion of surgery, the patient has a stable clinical and radiological result as well as a solid posterior fusion on CT. CONCLUSION: This is the first case published in which percutaneous magnetic distraction was successfully used in an adult patient.
BACKGROUND: We describe a case of severe and progressive lumbar hyperlordosis (160°) in a 28-year-old female university student with cerebral palsy. Her main complaints were abdominal wall pain and increasing inability to sit in her custom wheelchair. METHOD: When deciding on our opinion about the most promising treatment strategy, we contemplated slow continued correction by means of percutaneously expandable magnetic rods (MAGEC) after the index surgery as a key component of a satisfactory correction in this severe and rigid curve. After an initial radical release and partial correction, a release and correction procedure was required for the bilateral hip flexion contracture. A final in situ posterior fusion was performed as a second spinal procedure, once the desired final correction at 66° of lumbar lordosis was achieved. RESULT: Three years after the completion of surgery, the patient has a stable clinical and radiological result as well as a solid posterior fusion on CT. CONCLUSION: This is the first case published in which percutaneous magnetic distraction was successfully used in an adult patient.
Authors: Michael B Johnson; Liav Goldstein; Susan Sienko Thomas; Joseph Piatt; Michael Aiona; Michael Sussman Journal: J Pediatr Orthop Date: 2004 Sep-Oct Impact factor: 2.324