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A rare case of surgically managed multiple congenital thoraco-lumbar and lumbar block vertebrae with kypho-scoliosis and adjacent segment disease with myelopathy in a young female.

ABSTRACT: Spinal block vertebrae is a rare condition reported in 0.25% of South Asian population. This condition may not only result in deformity of lower back but also alter the bio-mechanics of spine leading to adjacent level degeneration and spinal canal stenosis. There is little literature evidence on surgical management of such a condition. Here we report a case of multiple congenital thoraco-lumbar and lumbar block vertebrae with lumbar kypho-scoliosis, adjacent segment disease and myelopathy in a young Asian female. She was operated with minimal possible instrumentation and decompression. Patient is pain free now and is able to walk without support, one year following the primary treatment.

SUBMITTER: Goel S

PROVIDER: S-EPMC7026526 | biostudies-literature | 2020 Mar-Apr

REPOSITORIES: biostudies-literature

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A rare case of surgically managed multiple congenital thoraco-lumbar and lumbar block vertebrae with kypho-scoliosis and adjacent segment disease with myelopathy in a young female.

Goel ShaktiA S Neshar AnsariMD A Chhabra H S HS

Journal of clinical orthopaedics and trauma 20190425 2

Spinal block vertebrae is a rare condition reported in 0.25% of South Asian population. This condition may not only result in deformity of lower back but also alter the bio-mechanics of spine leading to adjacent level degeneration and spinal canal stenosis. There is little literature evidence on surgical management of such a condition. Here we report a case of multiple congenital thoraco-lumbar and lumbar block vertebrae with lumbar kypho-scoliosis, adjacent segment disease and myelopathy in a y ...[more]

PMID: 32099296

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Project description:BackgroundAdjacent segment disease (ASDz) is a potential complication following lumbar spinal fusion. A common nomenclature based on etiology and ASDz type does not exist and is needed to assist with clinical prognostication, decision making, and management.Questions/purposesThe objective of this study was to develop an etiology-based classification system for ASDz following lumbar fusion.MethodsWe conducted a retrospective chart review of 65 consecutive patients who had undergone both a lumbar fusion performed by a single surgeon and a subsequent procedure for ASDz. We established an etiology-based classification system for lumbar ASDz with the following six categories: "degenerative" (degenerative disc disease or spondylosis), "neurologic" (disc herniation, stenosis), "instability" (spondylolisthesis, rotatory subluxation), "deformity" (scoliosis, kyphosis), "complex" (fracture, infection), or "combined." Based on this scheme, we determined the rate of ASDz in each etiologic category.ResultsOf the 65 patients, 27 (41.5%) underwent surgery for neurogenic claudication or radiculopathy for adjacent-level stenosis or disc herniation and were classified as "neurologic." Ten patients (15.4%) had progressive degenerative disc pathology at the adjacent level and were classified as "degenerative." Ten patients (15.4%) had spondylolisthesis or instability and were classified as "instability," and three patients (4.6%) required revision surgery for adjacent-level kyphosis or scoliosis and were classified as "deformity." Fifteen patients (23.1%) had multiple diagnoses that included a combination of categories and were classified as "combined."ConclusionThis is the first study to propose an etiology-based classification scheme of ASDz following lumbar spine fusion. This simple classification system may allow for the grouping and standardization of patients with similar pathologies and thus for more specific pre-operative diagnoses, personalized treatments, and improved outcome analyses.

Dataset Information

A rare case of surgically managed multiple congenital thoraco-lumbar and lumbar block vertebrae with kypho-scoliosis and adjacent segment disease with myelopathy in a young female.

Publications

A rare case of surgically managed multiple congenital thoraco-lumbar and lumbar block vertebrae with kypho-scoliosis and adjacent segment disease with myelopathy in a young female.

Similar Datasets

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