Skip to main content
Top
Published in: European Spine Journal 1/2017

01-05-2017 | Case Report

Long-term management of congenital lordoscoliosis of the thoracic spine

Authors: Kee-Yong Ha, Seung-Woo Suh, Young-Hoon Kim, Sang-Il Kim

Published in: European Spine Journal | Special Issue 1/2017

Login to get access

Abstract

Purpose

The objective of this study is to report the progression of congenital hyperlordoscoliosis in a 2-year-old patient and the use of multiple surgical interventions in the treatment of hyperlordoscoliosis of the thoracic spine.

Methods

A 2-year-old patient with thoracic hyperlordosis underwent observation for 1 year. To halt the progression of hyperlordosis, a posterior laminectomy was carried out to remove all the fused segments. Despite surgery, lordosis progressed via spontaneous autofusion with development of scoliosis with unilateral unsegmented bar. At the age of 9 years, the patient underwent posterior osteotomy at the fused segments, which was unsuccessful in the correction of hyperlordosis, but was successful in the correction of scoliosis. At the age of 12 years, the patient complained of mild breathing difficulties resulting from hyperlordosis of the thoracic spine, and underwent posterior multilevel vertebral osteotomy (PMVO) again to correct lordoscoliosis.

Results

Follow-up in the 3 years after PMVO showed that correction of the deformity was well maintained, with a good clinical outcome and a well-balanced spine.

Conclusions

PMVO is a potential intervention to manage rigid and severe congenital lordoscoliosis of the thoracic spine.
Literature
1.
go back to reference Bradford DS, Blatt JM, Rasp FL (1983) Surgical management of severe thoracic lordosis. A new technique to restore normal kyphosis. Spine (Phila Pa 1976) 8:420–428CrossRef Bradford DS, Blatt JM, Rasp FL (1983) Surgical management of severe thoracic lordosis. A new technique to restore normal kyphosis. Spine (Phila Pa 1976) 8:420–428CrossRef
2.
3.
go back to reference Kanagaraju V, Chhabra HS, Srivastava A, Mahajan R, Kaul R, Bhatia P, Tandon V, Nanda A, Sangondimath G, Patel N (2014) A case of severe and rigid congenital thoracolumbar lordoscoliosis with diastematomyelia presenting with type 2 respiratory failure: managed by staged correction with controlled axial traction. Eur Spine J. doi:10.1007/s00586-014-3624-0 Kanagaraju V, Chhabra HS, Srivastava A, Mahajan R, Kaul R, Bhatia P, Tandon V, Nanda A, Sangondimath G, Patel N (2014) A case of severe and rigid congenital thoracolumbar lordoscoliosis with diastematomyelia presenting with type 2 respiratory failure: managed by staged correction with controlled axial traction. Eur Spine J. doi:10.​1007/​s00586-014-3624-0
5.
6.
go back to reference Modi HN, Suh SW, Hong JY, Yang JH (2011) Posterior multilevel vertebral osteotomy for severe and rigid idiopathic and nonidiopathic kyphoscoliosis: a further experience with minimum two-year follow-up. Spine (Phila Pa 1976) 36:1146–1153. doi:10.1097/BRS.0b013e3181f39d9b CrossRef Modi HN, Suh SW, Hong JY, Yang JH (2011) Posterior multilevel vertebral osteotomy for severe and rigid idiopathic and nonidiopathic kyphoscoliosis: a further experience with minimum two-year follow-up. Spine (Phila Pa 1976) 36:1146–1153. doi:10.​1097/​BRS.​0b013e3181f39d9b​ CrossRef
7.
go back to reference Owange-Iraka JW, Harrison A, Warner JO (1984) Lung function in congenital and idiopathic scoliosis. Eur J Pediatr 142:198–200CrossRefPubMed Owange-Iraka JW, Harrison A, Warner JO (1984) Lung function in congenital and idiopathic scoliosis. Eur J Pediatr 142:198–200CrossRefPubMed
8.
go back to reference Winter RB, Lovell WW, Moe JH (1975) Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis. J Bone Joint Surg Am 57:972–977CrossRefPubMed Winter RB, Lovell WW, Moe JH (1975) Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis. J Bone Joint Surg Am 57:972–977CrossRefPubMed
10.
go back to reference Bjure J, Grimby G, Kasalicky J, Lindh M, Nachemson A (1970) Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis. Thorax 25:451–456CrossRefPubMedPubMedCentral Bjure J, Grimby G, Kasalicky J, Lindh M, Nachemson A (1970) Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis. Thorax 25:451–456CrossRefPubMedPubMedCentral
13.
go back to reference Suh SW, Modi HN, Yang J, Song HR, Jang KM (2009) Posterior multilevel vertebral osteotomy for correction of severe and rigid neuromuscular scoliosis: a preliminary study. Spine (Phila Pa 1976) 34:1315–1320. doi:10.1097/BRS.0b013e3181a028bc CrossRef Suh SW, Modi HN, Yang J, Song HR, Jang KM (2009) Posterior multilevel vertebral osteotomy for correction of severe and rigid neuromuscular scoliosis: a preliminary study. Spine (Phila Pa 1976) 34:1315–1320. doi:10.​1097/​BRS.​0b013e3181a028bc​ CrossRef
14.
go back to reference Yang JH, Suh SW, Cho WT, Hwang JH, Hong JY, Modi HN (2014) Effect of posterior multilevel vertebral osteotomies on coronal and sagittal balance in fused scoliosis deformity caused by previous surgery: preliminary results. Spine (Phila Pa 1976) 39:1840–1849. doi:10.1097/brs.0000000000000555 CrossRef Yang JH, Suh SW, Cho WT, Hwang JH, Hong JY, Modi HN (2014) Effect of posterior multilevel vertebral osteotomies on coronal and sagittal balance in fused scoliosis deformity caused by previous surgery: preliminary results. Spine (Phila Pa 1976) 39:1840–1849. doi:10.​1097/​brs.​0000000000000555​ CrossRef
Metadata
Title
Long-term management of congenital lordoscoliosis of the thoracic spine
Authors
Kee-Yong Ha
Seung-Woo Suh
Young-Hoon Kim
Sang-Il Kim
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 1/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4711-1

Other articles of this Special Issue 1/2017

European Spine Journal 1/2017 Go to the issue