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Post a Comment Surgical treatment of congenital kyphosis caused by multiple vertebral malformations
- Authors: Kosulin A.V.1, Elyakin D.V.1, Okhlopkova E.I.1, Pridatko O.G.1, Klybanskaya Y.V.1, Dvoretskiy V.S.1
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Affiliations:
- St. Petersburg State Pediatric Medical University
- Issue: Vol 9, No 1 (2018)
- Pages: 112-117
- Section: Articles
- URL: https://journal-vniispk.ru/pediatr/article/view/8744
- DOI: https://doi.org/10.17816/PED91112-117
- ID: 8744
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Abstract
Clinical case of successful operative treatment of congenital kyphosis is reported. Deformation was caused by multiple lower thoracic and lumbar vertebral body abnormalities. Associated spinal abnormalities were outspread absence of laminae, hydromyelia, and diastematomyelia. Preoperative computed tomography analysis revealed absence of instrumentable bony structures within malformed lower thoracic and lumbar spine. As instrumented fusion procedure was technically impossible anterior fusion without internal fixation was performed. Autogenous rib was used as a bone graft. Bone graft was extended with calcium sulphas (osteoconductive media), demineralized allograft bone matrix (osteoinductive media), and patient’s bone marrow aspirate (osteogenic media). Resulting combined bone grafting material possessed osteoconductivity, osteoinductivity, ostegenicity, and mechanical strength. At 18 months post operation follow-up computed tomography revealed solid bony fusion formation. Some neurologic improvement also was noticed. Congenital kyphosis caused by multiple outspread vertebral malformations remains insufficiently studied clinical problem. Affected children need individual multidisciplinary surgical approach, meticulous surgical planning, and regular neurological, imaging, and orthopedic follow-up until the end of bone growth. Absence of instrumentable bony structures in desired spinal arthrodesis does not preclude successful fusion. Combination of several heterogenous bone grafting materials with different properties provides fusion in difficult clinical setting.
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##article.viewOnOriginalSite##About the authors
Artem V. Kosulin
St. Petersburg State Pediatric Medical University
Author for correspondence.
Email: hackenlad@mail.ru
Assistant Professor, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgDmitriy V. Elyakin
St. Petersburg State Pediatric Medical University
Email: dimaelkins@mail.ru
Pediatric Surgeon, Surgical Department No 2
Russian Federation, Saint PetersburgEkaterina I. Okhlopkova
St. Petersburg State Pediatric Medical University
Email: oket2008@rambler.ru
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgOlesya G. Pridatko
St. Petersburg State Pediatric Medical University
Email: seventhseeker@yandex.ru
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgYuliya V. Klybanskaya
St. Petersburg State Pediatric Medical University
Email: julieklyban@gmail.com
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgVladislav S. Dvoretskiy
St. Petersburg State Pediatric Medical University
Email: butler4@mail.ru
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgReferences
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