Jianfeng Guo1, Qian Guo1, Jing Li2, Zhong Fang1, Hui Liao1, Wei Xiong1, Feng Li3. 1. Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei. 2. Department of Orthopedics, The First Affiliated Hospital of Medical School, Shihezi University, Shihezi. 3. Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei. Electronic address: lifengmd@hust.edu.cn.
Abstract
BACKGROUND: Congenital kyphosis due to wedge hemivertebra is an uncommon spinal deformity that could progressively develop into sagittal imbalance accompanied by subsequent neurologic deterioration if no intervention is performed. Numerous surgical techniques have been reported, since congenital kyphosis has shown no response to conservative treatments. Currently, osteotomy procedures, which are considered technically demanding and risky, have become the mainstream techniques for the correction of congenital kyphosis. METHODS: We describe the use of a novel surgical procedure combining forward-shifting of anterior column of the wedge hemivertebra and circumferential fusion for treatment of congenital kyphosis secondary to a wedge hemivertebra in a case of a 13-year-old boy who showed a 49° angular kyphosis from T12 to L2 secondary to a wedge hemivertebra in L1. RESULTS: The focal kyphosis was corrected to 5° with a correction rate of 89.8% after operation, and the sagittal balance was significantly preserved with no complication. Solid fusion was detected at the final follow-up. CONCLUSIONS: This novel procedure, combining forward-shifting of anterior column of the wedge hemivertebra and circumferential fusion, is a feasible, effective, and safe technique for the treatment of some special type 1 congenital kyphosis cases, with a high correction rate and no major complications.
BACKGROUND:Congenital kyphosis due to wedge hemivertebra is an uncommon spinal deformity that could progressively develop into sagittal imbalance accompanied by subsequent neurologic deterioration if no intervention is performed. Numerous surgical techniques have been reported, since congenital kyphosis has shown no response to conservative treatments. Currently, osteotomy procedures, which are considered technically demanding and risky, have become the mainstream techniques for the correction of congenital kyphosis. METHODS: We describe the use of a novel surgical procedure combining forward-shifting of anterior column of the wedge hemivertebra and circumferential fusion for treatment of congenital kyphosis secondary to a wedge hemivertebra in a case of a 13-year-old boy who showed a 49° angular kyphosis from T12 to L2 secondary to a wedge hemivertebra in L1. RESULTS: The focal kyphosis was corrected to 5° with a correction rate of 89.8% after operation, and the sagittal balance was significantly preserved with no complication. Solid fusion was detected at the final follow-up. CONCLUSIONS: This novel procedure, combining forward-shifting of anterior column of the wedge hemivertebra and circumferential fusion, is a feasible, effective, and safe technique for the treatment of some special type 1 congenital kyphosis cases, with a high correction rate and no major complications.