International Journal of Research in Medical Sciences | February 2019 | Vol 7 | Issue 2 Page 613
International Journal of Research in Medical Sciences
Yudistira A et al. Int J Res Med Sci. 2019 Feb;7(2):613-615
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Case Report
Correction of kyphotic deformity due to neglected fracture dislocation
thoracolumbar spine with posterior vertebral column resection
Andhika Yudistira, Syaifullah Asmiragani, Ery Satriawan*
INTRODUCTION
Kyphotic deformity is serious problem for sagittal spinal
balance and resulting back pain, neurologic impairment,
and cosmetic problem. The etiologies of kyphosis include
degerative disc disease, neuromuscular disease, spinal
tumors, post-traumatic and surgical iatrogenic causes.
1,2
Post traumatic kyphotic deformity most common occur
following unstable spine. Laminectomy as an isolated
procedure for spinal cord decompression in burst fracture
or fracture dislocation should not be performed as it
increase instability, promotes neurological deficits and
progression of khyposis.
3,4
We reporting a case of
progressive after traumatic kyphotic deformity due to
fracture dislocation which was performed laminectomy
without posterior instrumentation.
CASE REPORT
A 34-years-old female was admitted to the hospital due to
pain in the back and unable to move both lower extremity
since 1 year previously. Patient brought to the hospital
and underwent surgery. Previous surgery just performed
laminectomy for neural decompression without any
reduction and instrumentation. From the initial
thoracolumbar x-ray after trauma, there was fracture
dislocation of thoracic XII-lumbar I vertebra with
regional Cobb’s angle 30 degrees and progression of
khyposis became 50 degrees (Figure 1).
We performed posterior decompression, posterior
instrumentation and kyphotic deformity correction by
total poterior spondylectomy (VCR) of vertebra lumbar I
and anterior column bone graft using corticocancelous
graft (fibula). There was no laceration nor transection of
spinal cord (Figure 2).
One day after surgery, patient recovered well without any
complication. From the thoracolumbar radiograph, cobb’s
angle was decreased to 12 degrees. One week after
surgery, patient started to feel burning sensation in both
lower leg and also pain was decrease significantly with
ABSTRACT
Kyphotic deformity is serious problem for sagittal spinal balance and resulting back pain, neurologic impairment, and
also cosmetic problem. Post traumatic kyphotic deformity most common occur following unstable spine. A
circumferential approach with anterior release via discectomies and corpectomies, followed by posterior
instrumentation and fusion has been the standard of care. This is a case of progressive post traumatic kyphotic
deformity due to fracture dislocation which was performed laminectomy without posterior instrumentation and
succesfully corrected with single step posterior vertebral column resection.
Keywords: Kyphotic deformities, Laminectomy, Posterior vertebral column resection, Thoracolumbar fracture-
dislocation
Spine Division of Department of Orthopedic & Traumatology, Brawijaya University, Saiful Anwar General Hospital
Malang, East Java, Indonesia
Received: 18 November 2018
Accepted: 29 December 2018
*Correspondence:
Dr. Ery Satriawan,
E-mail: ery_triple8@yahoo.co.id
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20190366