Closing-opening vertebral column resection for thoracolumbar congenital kyphosis: technical note and case report.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-05-25 DOI:10.1007/s43390-025-01108-w

Anouar Bourghli, Louis Boissiere, Faisal Konbaz, Cecile Roscop, Khaled Almusrea, Ibrahim Obeid

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引用次数: 0

Abstract

Purpose: To describe the technique of closing-opening vertebral column resection (COVCR) in an adult patient with severe thoracolumbar kyphosis secondary to two adjacent posterior hemivertebrae.

Background: COVCR is a rare technique as it can only be applied in a very specific deformity configuration.

Methods: We report the case of a 26-year-old male who has been complaining of middle and low back pain for over 10 years with difficulties when walking for long distances. Full spine anteroposterior and lateral X-rays revealed a severe thoracolumbar kyphosis with an angulation of 95° between T10 and L1. CT scan confirmed the presence of two adjacent posterior hemivertebrae at the level of T11 and T12. MRI did not show any spinal cord anomalies.

Results: The patient underwent a posterior resection of T11 and T12 vertebrae with instrumentation from T7 to L4. Through the use of a side-to-side domino connector, closing of the middle column and opening of the anterior column were achieved demonstrating a COVCR. No cage was inserted. Thoracolumbar kyphosis was corrected to 25°. He could walk on day 2 with a satisfactory clinical and radiological result at 2 years.

Conclusion: This is the first paper to describe the true COVCR as a surgical technique for the management of congenital thoracolumbar kyphosis. Such variation of VCR may be applied in the presence of a posterior hemivertebra where the configuration enables opening of the anterior column and closing of the middle column.

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闭式-开式脊柱切除术治疗胸腰椎先天性后凸：技术笔记及病例报告。

目的：描述闭合-开放椎体切除术（COVCR）治疗两相邻后半椎体继发性严重胸腰椎后凸的成人患者的技术。背景：COVCR是一种罕见的技术，因为它只能应用于非常特殊的畸形配置。方法：我们报告的情况下，一个26岁的男性谁一直抱怨中腰痛超过10年，行走时长距离困难。全脊柱正位和侧位x光片显示严重的胸腰椎后凸，T10和L1之间成95°角。CT扫描证实在T11和T12水平处存在两个相邻的后半椎体。MRI未见脊髓异常。结果：患者接受了T11和T12椎体后部切除术，并从T7到L4进行了内固定。通过使用侧对侧骨牌连接器，实现了中柱的关闭和前柱的打开，证明了COVCR。没有插入笼子。胸腰椎后凸矫正至25°。术后第2天即可行走，2年临床和放射学结果满意。结论：这是第一篇描述COVCR作为治疗先天性胸腰椎后凸的外科技术的论文。这种VCR的变化可以应用于存在后半椎体的情况，其中所述结构可以打开前柱并关闭中柱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.