Is VCR necessary to correct very severe deformity? case report and review of literature.

The International Journal of Neuroscience
Abhinandan Reddy MallepallyH S Chhabra

Abstract

Background: Management of severe scoliotic deformities is challenging. Deformity correction may need three column osteotomies that may be associated with significant morbidity. Staged procedure and use of Halo gravity traction is a useful strategy in such cases.Case Description: A thirty-year-old woman presented with complaint of progressive deformity over the back for the past few years. She was very frail as per the adult spine deformity frailty index (ASD-FI), and her BMI was less than 18. Her Cobb angle measured 180 degrees of main thoracic curve. Her pulmonary function was compromised and had dyspnea on exertion. Management options in these deformities are limited and fraught with risk of major complications. To correct these deformities, a 2-3 level vertebral column resection (VCR) is required using an all-posterior approach. This patient was treated by anterior release followed by halo-gravity traction (HGT) for two weeks, which was then followed by posterior release and correction. The Cobb angle was reduced from 180° to 55° at final follow up of 2 years.Conclusion: Anterior release and traction can help in obviating the vertebral column resection in these severe rigid U-shaped deformities.

References

May 1, 1996·Journal of Pediatric Orthopedics·B A RawlinsA L Ozolins
Oct 2, 2008·BMC Geriatrics·Samuel D SearleKenneth Rockwood
Jul 11, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jorge PayoAlfredo Garcia
Nov 2, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Heiko KollerWolfgang Hitzl
Jun 25, 2016·Asian Spine Journal·Sravisht IyerHan Jo Kim
Nov 20, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Changsheng YangSamuel Cho
Jul 1, 2017·Global Spine Journal·Comron SaifiLawrence G Lenke
Jul 4, 2017·Asian Spine Journal·Pankaj KandwalArvind Jayaswal

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