Spine deformity · 2025
Closing-opening vertebral column resection for thoracolumbar congenital kyphosis: technical note and case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Bourghli Anouar, Boissiere Louis, Konbaz Faisal, Roscop Cecile, Almusrea Khaled, Obeid Ibrahim
Аннотация
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.
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.