Abstract
Study Design
Case report.
Objective
To report the clinical and imaging findings of a patient with lumbar stenosis 44 years after posterior spinal fusion for congenital lumbar kyphosis.
Summary of Background Data
To our knowledge, there are no long-term follow-up reports after posterior spine fusion (PSF) for congenital kyphosis. Congenital kyphosis is an uncommon deformity with the potential to progress rapidly and result in deformity and neurologic deficits.
Methods
We report the patient’s history, physical examination, imaging findings, and management in addition to providing a literature review.
Results
A 54-year-old-male who underwent T8–L3 PSF in 1972 because of congenital kyphosis presented 44 years after surgery with lower back pain, buttock, and bilateral posterior leg pain. On physical examination, no weakness was elicited and magnetic resonance imaging demonstrated L4–L5 lumbar stenosis. The patient was enrolled in physical therapy and responded well to medical/interventional management.
Conclusion
To our knowledge, this is the longest follow-up of surgical management of congenital lumbar kyphosis. Posterior fusion only halted the progression of the kyphosis with subsequent developed of adjacent segment disease distal to the fusion.
Level of Evidence
Level IV.
Similar content being viewed by others
References
Winter RB, Moe JH, Wang JF. Congenital kyphosis. Its natural history and treatment as observed in a study of one hundred and thirty patients. J Bone Joint Surg Am 1973;55:223–56.
McMaster MJ, Singh H. Natural history of congenital kyphosis and kyphoscoliosis. A study of one hundred and twelve patients. J Bone Joint Surg 1999;81:1367–83.
McMaster MJ, Singh H. The surgical management of congenital kyphosis and kyphoscoliosis. Spine 2001;26:2146–54.
Bollini G, Docquier PL, Viehweger E, et al. Thoracolumbar hemivertebrae resection by double approach in a single procedure: long-term follow-up. Spine (Phila Pa 1976) 2006;31:1745–57.
Ruf M, Jensen R, Letko L, Harms J. Hemivertebra resection and osteotomies in congenital spine deformity. Spine (Phila Pa 1976) 2009;34:1791–9.
Winter RB, Turek-Shay LA. Twenty-eight-year follow-up of anterior and posterior fusion for congenital kyphosis: a case report. Spine 1997;22:2183–7.
Winter RB, Moe JH, Lonstein JE. The surgical treatment of congenital kyphosis. A review of 94 patients age 5 years or older, with 2 years or more follow-up 77 patients. Spine (Phila Pa 1976) 1985;10:224–31.
Noordeen MH, Garrido E, Tucker SK, Elsebaie HB. The surgical treatment of congenital kyphosis. Spine (Phila Pa 1976) 2009;34:1808–14.
Smith JT, Gollogly S, Dunn HK. Simultaneous anterior-posterior approach through a costotransversectomy for the treatment of congenital kyphosis and acquired kyphoscoliotic deformities. J Bone Joint Surg Am 2005;87:2281–9.
Kim YJ, Otsuka NY, Flynn JM, et al. Surgical treatment of congenital kyphosis. Spine (Phila Pa 1976) 2001;26:2251–7.
Hodgson AR. Correction of fixed spinal curves: a preliminary communication. J Bone Joint Surg Am 1965;47:1221–7.
Ghiselli G, Wang JC, Bhatia NN, et al. Adjacent segment degeneration in the lumbar spine. J Bone Joint Surg Am 2004;86:1497–503.
Wang S, Aikenmu K, Zhang J, et al. The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis. Eur Spine J 2015 [Epub ahead of print].
Wang Y, Kawakami N, Tsuji T, et al. Proximal junctional kyphosis following posterior hemivertebra resection and short fusion in children younger than 10 years. Clin Spine Surg 2017;30:E370–6.
Aydogan M, Ozturk C, Tezer M, et al. Posterior vertebrectomy in kyphosis, scoliosis and kyphoscoliosis due to hemivertebra. J Pediatr Orthop B 2008;17:33–7.
Lamartina C, Berjano P. Paraplegia after posterior only correction of congenital kyphosis. Eur Spine J 2011;20:1582–3.
Author information
Authors and Affiliations
Corresponding author
Additional information
Author disclosures: None.
Rights and permissions
About this article
Cite this article
Baldwin, A., Mesfin, A. Adjacent Segment Disease 44 Years Following Posterior Spinal Fusion for Congenital Lumbar Kyphosis. Spine Deform 5, 435–439 (2017). https://doi.org/10.1016/j.jspd.2017.04.006
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.jspd.2017.04.006