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KMID : 1141120190050010018
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The Nerve
2019 Volume.5 No. 1 p.18 ~ p.21
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Posterior Vertebral Column Resection for Pediatric Congenital Kyphosis: A Case Report and Technical Concerns
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Kim Jun-Hyung
Choi Un-Yong
Kim Kyung-Hyun
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Abstract
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Treatment of severe congenital kyphosis in pediatric patients is challenging. Posterior vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column, although it is technically demanding. A 12-year-old male who had been previously diagnosed with spine deformity due to the type 1 cervicothoracic junction kyphosis presented with progressive lower extremity paraparesis of motor grade 2. On spine X-rays, the cervical lordosis was 70.3°, the thoracic kyphosis was 47.3°, and the lumbar lordosis was -18.5°. To correct the patient's cervicothoracic kyphosis, we performed a PVCR of T1-T5, and posterior screw fixations of C5-C7 and T6-T8. Intraoperative monitoring was attempted, but did not provide detectable signals during the operation. Imaging studies on post-operative day 3 demonstrated cervical lordosis was 35.6°, and the Cobb angle of C7-T6 was 29.3°. The patient neurological status improved from category C on the American Spinal Association Scale to category D, and was discharged without major complications. PVCR can offer several advantages such as providing larger correction angles and allowing both posterior and anterior manipulation of the spine from a single approach. Due to technical difficulties, a surgeon must thoroughly evaluate the surgical plan in order to avoid lethal complications.
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KEYWORD
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Congenital kyphosis, Pediatric deformity, Type 6 osteotomy, Vertebral column osteotomy
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