scholarly journals Surgical treatment of severe congenital kyphosis in an adult patient: rare clinical observation and a brief literature review

2018 ◽  
Vol 15 (4) ◽  
pp. 21-26
Author(s):  
V. V. Novikov ◽  
A. Yu. Sergunin ◽  
V. V. Belozerov ◽  
M. N. Lebedeva ◽  
A. S. Vasyura ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adult Patient ◽  
Thoracolumbar Spine ◽  
Deformity Correction ◽  
Neurological Complications ◽  
The Body ◽  
Bone Block ◽  
Vertebral Column Resection ◽  
Congenital Kyphosis ◽  
Mesh Cage

The paper presents a clinical case of surgical treatment of an adult patient with severe rigid congenital kyphosis developed due to multiple anomalies in the thoracolumbar spine. Surgical intervention included vertebral column resection (VCR) and the deformity correction using segmental third-generation instrumentation with transpedicular fixation. The VCR made it possible to correct the relationship between vertebrae in the anomaly zone, to improve the shape of the spinal canal and increase its volume, and to achieve apparent mobility of the spine at the apex of the kyphosis. Preservation of the anterosuperior portion of the body of the resected vertebra allowed avoiding anterior mesh cage use to support and reconstruct the anterior supporting column of the resected segment. This enabled performing necessary correction of severe kyphotic deformity, reduced the risk of neurological complications, and favored the formation of solid bone block in the long-term period after surgery.

Surgical Treatment of Congenital Kyphosis

2013 ◽  
Vol 20 (4) ◽  
pp. 34-40
Author(s):  
S. V Kolesov ◽  
A. A Snetkov ◽  
M. L Sazhnev ◽  
A. N Shaboldin
Keyword(s):  
Surgical Treatment ◽  
Vertebral Column ◽  
Thoracolumbar Spine ◽  
Surgical Techniques ◽  
Treatment Results ◽  
Vertebral Column Resection ◽  
Neurologic Disorders ◽  
Congenital Kyphosis ◽  
Spine Development ◽  
Spinal Cord Decompression

Surgical treatment results of 24 patients, aged 3 — 57 years, with congenital kyphotic deformities of thoracolumbar spine are presented. Disturbance of vertebrae formation was diagnosed in 13 patients, segmentation disorder — in 4, mixed abnormalities — in 1, nonclassifying abnormalities — in 3, congenital dislocations (subluxation) — in 3 patients. Neurologic disorders were observed in 12 patients. Five surgical techniques were used for the treatment of congenital kyphotic deformities: posterior fusion (8 patients), combined dorsal and ventral fixation (6), spinal cord decompression in combination with correction and stabilization (4), resection of hemivertebra (3), VCR (Vertebral Column Resection — 4). After surgical correction the angle of kyphotic deformity made up from 7 to 68° (mean 42°), degree of correction from 6 to 84% (mean 34%). Differentiated use of surgical techniques enables to achieve good treatment results, formation of proper frontal and sagittal balance as well as to create conditions for an adequate spine development.

scholarly journals SURGICAL TREATMENT OF CONGENITAL DEFORMATION OF THORACOLUMBAR SPINE IN CHILDREN

2013 ◽  
Vol 1 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Sergey Valentinovich Vissarionov ◽  
Dmitriy Nikolaevich Kokushin ◽  
Sergey Mikhailovich Belyanchikov ◽  
Vladislav Valerevich Murashko ◽  
Kirill Alexandrovich Kartavenko
Keyword(s):  
Surgical Treatment ◽  
Thoracolumbar Spine ◽  
Deformity Correction ◽  
Metal Structure ◽  
Posterior Spinal Fusion ◽  
Neurological Complications ◽  
Long Term Results ◽  
Patients Âgés ◽  
Local Bone ◽  
Minimum Number

The analysis of the results of surgical treatment of 32 patients with congenital spinal de formity against lateral and posterolateral hemivertebrae in the area of the thoracolumbar junction was carried out. The patients' ages ranged from 1.2 to 4 years old, 11 boys and 21 girls. Terms of postoperative follow-up were from 2 to 10 years. The angle of scoliosis before surgery was from 26 to 52, kyphosis - from 12 to 56. Surgical intervention was performed with the combined approach in the amount of extirpation of abnormal vertebrae with surrounding disks, deformity correction with dorsal metalwork, corporodesis and posterior fusion with local bone autograft. Metal structure was removed in 1.5-2 years after surgery. Correction of scoliosis was 94-100 %, kyphotic - 82-90 %. The progression of deformation, neurological complications and joining of the dysplastic process were not observed. In assessing of the long-term results, scoliosis curve ranged from 0 to 8 (average - 4.2), kyphotic from 0 to 10 (average - 5.1). The progression of the spinal deformity with hemivertebrae in the area of the thoracolumbar transition requires early surgical elimination of the defect with a full radical correction of congenital deformation, restoration of the anatomy of the spinal canal and the physiological curves of the spine at the level of deformation with fixation of a minimum number of spinal motion segments with metal construction and bone plastic stabilization (front and posterior spinal fusion).

scholarly journals Surgical Treatment of Congenital Kyphosis Associated With Progressive Spastic Paralysis in an Adult Patient

2006 ◽  
Vol 46 (6) ◽  
pp. 313-317 ◽  
Author(s):  
Hiroshi NOMURA ◽  
Kazumasa TERADA ◽  
Nobuo KOBARA ◽  
Kiyoshi MIYAZAKI ◽  
Michitaka YUASA ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adult Patient ◽  
Spastic Paralysis ◽  
Congenital Kyphosis

CONGENITAL THORACOLUMBAR SPINE DEFORMITIES

Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A78-A85 ◽  
Author(s):  
Hamidreza Aliabadi ◽  
Gerald Grant
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Congenital Anomalies ◽  
Thoracolumbar Spine ◽  
Deformity Correction ◽  
Spinal Deformities ◽  
Spine Deformities ◽  
Frequent Reason

ABSTRACT CONGENITAL THORACOLUMBAR SPINAL deformities are a common and frequent reason for referral to spine surgeons. Neurosurgeons also treat many neurological diagnoses which may result in a progressive spinal deformity, such as scoliosis. Here we review a variety of congenital anomalies and address the maldevelopments associated with each, as well as the appropriate evaluation of such patients including nonoperative and operative approaches. Advances in the field of spinal deformity correction now allow us to better treat individuals with these types of deformities. It is important for the practicing neurosurgeon to be knowledgeable of surgical and nonsurgical treatments of patients with congenital thoracolumbar spinal deformities in order to better understand which patients will ultimately progress and necessitate surgical treatment.

Correction of Spine Pathology in Patients with Meningocele

2013 ◽  
Vol 20 (1) ◽  
pp. 46-52
Author(s):  
S. V Kolesov ◽  
A. N Baklanov ◽  
I. A Shavyrin
Keyword(s):  
Surgical Treatment ◽  
Life Quality ◽  
Deformity Correction ◽  
Vertebral Column Resection ◽  
Scoliotic Deformity ◽  
Average Curvature ◽  
Spine Instrumentation ◽  
Spine Deformities ◽  
Spine Pathology ◽  
Trunk Balance

Treatment results for 8 patients aged 3 to 17 years with neuromuscular spine deformities on the background of meningocele are presented. In all patients spine deformities were accompanied by spinal dysraphias. Average curvature arch was 86°. Surgical treatment was performed either in one (5patients) or in two (3 patients) steps. In 2 patients vertebral column resection (VCR) was performed. Average achieved scoliotic deformity correction made up62% and postoperative value of thoracic/thoracolumbar kyphosis approximated the physiologic one (40°). Surgical treatment of kyphoscoliosis on the background of meningocele that consisted of extensive spine instrumentation with pelvis fixation favoured the normalization of trunk balance, improved cardiopulmonary function, patients’ appearance and life quality. In this group of patients surgical intervention is associated with high intraoperative risk and rate of postoperative complications.

scholarly journals Halo-gravity traction in the treatment of complex (>100°) scoliotic deformities of the spine in children: a review of clinical cases

2020 ◽  
pp. 67-71
Author(s):  
A.F. Levytskyi ◽  
◽  
V.A. Rogozinskyi ◽  
M.M. Dolianytskyi ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Deformity Correction ◽  
Neurological Complications ◽  
Spinal Deformities ◽  
Specialized Hospital ◽  
Definition Of ◽  
Type 3

Relevance. The definition of «complex spinal deformity» remains rather vague, but in most publications mark it as a deformation, which on average exceeds 100 degrees. Modern surgical practice of one-stage correction of complex spinal deformities includes performing osteotomies of the spine, which significantly improves the possibility of deformity correction, but also increases the risk of neurological complications and the volume of intraoperative blood loss. The aim. To improve the results of surgical treatment of patients with complex spinal deformities through the preliminary use of halogravitational traction and to establish an effective and safe algorithm for the treatment of complex spinal deformities in children. Materials and methods. During the period from 2008 to 2018, the Orthopedic and Traumatology Department of the National Children’s Specialized Hospital «OKHMATDYT» treated 48 children with complex spinal deformities (>100°) using halo-gravity traction. Of these, 32 are boys and 16 are girls. The average age of the patients was 12.9 years. The average Risser score was 4.2 (P>0.01). 27.1% of patients had type 1 deformity according to Lenke, type 2 – 54.1%, type 3 – 8.3%, type 4 – 6.4%, type 5 – 4.1%. Results and discussion. Using of halo- gravity traction for the preoperative reduction of spinal deformity and prevention of neurological disorders, the average duration of spinal traction application was 46 (P>0.01) days. A weight of 40–50% of the patient’s body weight was used. After the stage of halo-gravity traction, the spine was stabilized with a polysigmentary construction. Conclusion. Halo-gravity traction as a first stage of severe scoliotic spinal deformations treatment allows to increase the mobility of the vertebral column and to adjust spinal cord step by step for the next correction treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: spinal deformity, halo-gravity traction, surgical treatment.

scholarly journals Beneficial Effects of Surgical Treatment of Compressive Myelopathy in Patients With Severe Angular Kyphosis of Thoracolumbar Spine: A Retrospective Study of 12 Cases

2020 ◽  
Vol 7 (3) ◽  
pp. 94-104
Author(s):  
Hasan Ghandhari ◽  
◽  
Farshad Nikouei ◽  
Ebrahim Ameri ◽  
Mansour Karimi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Spinal Fusion ◽  
Spinal Injury ◽  
Thoracolumbar Spine ◽  
Congenital Kyphosis ◽  
Anterior Corpectomy ◽  
Angular Kyphosis ◽  
The Mean ◽  
Compressive Myelopathy

Background: Severe angular kyphosis is one of the uncommon etiologies of compressive myelopathy and hence, many aspects of this myelopathy are unknown.  Objectives: In this study, we report a series of 12 patients with compressive myelopathy in severe angular kyphosis, as well as the result of surgical treatment in these patients. Methods: In a retrospective study, we included 12 patients with the progressive or sudden onset of paraplegia caused by severe angular kyphosis. The neurological status of the patients was evaluated with the American Spinal Injury Association (ASIA) typing system before the operation and at four time points after the operation (1 day, 1 week, 6 months, 1 year). The main surgical interventions included anterior corpectomy, anterior spinal fusion, and posterior spinal fusion with or without instrumentation and with or without decompression. Results: The Mean±SD age of the patients was 41.9±16.4 years, ranging from 14 to 59 years. The etiology of myelopathy was congenital kyphosis in 10 patients (83.3%). The Mean±SD duration of paralysis was 6.4±6.6 months. The Mean±SD percentage of cord thinning at the apex was 61.7±17.5%. Bowel or bladder dysfunction was present in 6 patients (50%) before the surgery that was resolved in 5 patients after the surgery. One year after the surgery, the ASIA typing was improved in 9 patients (75%) and remained the same as preoperative status in 3 patients (25%). Conclusion: Surgical decompression corrects the neurological symptoms in the majority of cases with compressive myelopathy caused by severe angular kyphosis.

scholarly journals SARS-CoV-2: is there neuroinvasion?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Conor McQuaid ◽  
Molly Brady ◽  
Rashid Deane
Keyword(s):  
Respiratory Distress ◽  
Vascular Dysfunction ◽  
Multiorgan Failure ◽  
Neurological Complications ◽  
Wide Distribution ◽  
The Body ◽  
Health Conditions ◽  
Main Body ◽  
Beneficial Effects ◽  
The Brain

Abstract Background SARS-CoV-2, a coronavirus (CoV), is known to cause acute respiratory distress syndrome, and a number of non-respiratory complications, particularly in older male patients with prior health conditions, such as obesity, diabetes and hypertension. These prior health conditions are associated with vascular dysfunction, and the CoV disease 2019 (COVID-19) complications include multiorgan failure and neurological problems. While the main route of entry into the body is inhalation, this virus has been found in many tissues, including the choroid plexus and meningeal vessels, and in neurons and CSF. Main body We reviewed SARS-CoV-2/COVID-19, ACE2 distribution and beneficial effects, the CNS vascular barriers, possible mechanisms by which the virus enters the brain, outlined prior health conditions (obesity, hypertension and diabetes), neurological COVID-19 manifestation and the aging cerebrovascualture. The overall aim is to provide the general reader with a breadth of information on this type of virus and the wide distribution of its main receptor so as to better understand the significance of neurological complications, uniqueness of the brain, and the pre-existing medical conditions that affect brain. The main issue is that there is no sound evidence for large flux of SARS-CoV-2 into brain, at present, compared to its invasion of the inhalation pathways. Conclusions While SARS-CoV-2 is detected in brains from severely infected patients, it is unclear on how it gets there. There is no sound evidence of SARS-CoV-2 flux into brain to significantly contribute to the overall outcomes once the respiratory system is invaded by the virus. The consensus, based on the normal route of infection and presence of SARS-CoV-2 in severely infected patients, is that the olfactory mucosa is a possible route into brain. Studies are needed to demonstrate flux of SARS-CoV-2 into brain, and its replication in the parenchyma to demonstrate neuroinvasion. It is possible that the neurological manifestations of COVID-19 are a consequence of mainly cardio-respiratory distress and multiorgan failure. Understanding potential SARS-CoV-2 neuroinvasion pathways could help to better define the non-respiratory neurological manifestation of COVID-19.

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