Skip to main content
SpringerLink
Log in

Long-term management of congenital lordoscoliosis of the thoracic spine

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

References

  1. Bradford DS, Blatt JM, Rasp FL (1983) Surgical management of severe thoracic lordosis. A new technique to restore normal kyphosis. Spine (Phila Pa 1976) 8:420–428

    Article  CAS  Google Scholar 

  2. Winter RB (1992) Surgical correction of rigid thoracic lordoscoliosis. J Spinal Disord 5:108–111

    Article  CAS  PubMed  Google Scholar 

  3. 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

    Google Scholar 

  4. Ghandhari H, Tari HV, Ameri E, Safari MB, Fouladi DF (2015) Vertebral, rib, and intraspinal anomalies in congenital scoliosis: a study on 202 Caucasians. Eur Spine J 24:1510–1521. doi:10.1007/s00586-015-3833-1

    Article  PubMed  Google Scholar 

  5. Weiss HR, Moramarco M (2016) Congenital Scoliosis (Mini-review). Curr Pediatr Rev 12:43–47

    Article  PubMed  Google Scholar 

  6. 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

    Article  Google Scholar 

  7. Owange-Iraka JW, Harrison A, Warner JO (1984) Lung function in congenital and idiopathic scoliosis. Eur J Pediatr 142:198–200

    Article  CAS  PubMed  Google Scholar 

  8. 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 57:972–977

    Article  CAS  PubMed  Google Scholar 

  9. Bergofsky EH (1979) Respiratory failure in disorders of the thoracic cage. Am Rev Respir Dis 119:643–669. doi:10.1164/arrd.1979.119.4.643

    CAS  PubMed  Google Scholar 

  10. Bjure J, Grimby G, Kasalicky J, Lindh M, Nachemson A (1970) Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis. Thorax 25:451–456

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Ting EY, Lyons HA (1964) THE RELATION OF PRESSURE AND VOLUME OF THE TOTAL RESPIRATORY SYSTEM AND ITS COMPONENTS IN KYPHOSCOLIOSIS. Am Rev Respir Dis 89:379–386. doi:10.1164/arrd.1964.89.3.379

    CAS  PubMed  Google Scholar 

  12. Bartlett W, Garrido E, Wallis C, Tucker SK, Noordeen H (2009) Lordoscoliosis and large intrathoracic airway obstruction. Spine (Phila Pa 1976) 34:E59–E65. doi:10.1097/BRS.0b013e318191f389

    Article  Google Scholar 

  13. 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

    Article  Google Scholar 

  14. 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

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Korea

    Kee-Yong Ha, Young-Hoon Kim & Sang-Il Kim

  2. Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea

    Seung-Woo Suh

Authors
  1. Kee-Yong Ha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seung-Woo Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Young-Hoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sang-Il Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kee-Yong Ha.

Ethics declarations

Conflict of interest

None of the authors has any potential conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ha, KY., Suh, SW., Kim, YH. et al. Long-term management of congenital lordoscoliosis of the thoracic spine. Eur Spine J 26 (Suppl 1), 47–52 (2017). https://doi.org/10.1007/s00586-016-4711-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-016-4711-1

Keywords

Search

Navigation