C7–T1 Anterior Closing Wedge Bone-Disc-Bone Osteotomy for the Treatment of Cervical Hyperlordosis in Muscular Dystrophy

Köse, Kamil Çağrı; Caliskan, Islam; Bal, Emre; İnanmaz, Mustafa Erkan; Işık, Cengiz

doi:10.1097/brs.0000000000000433

Cited by 12 publications

(18 citation statements)

References 13 publications

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“…An anterior cervical spine locking plate was used for achieving stabilization. Kose et al [9] reported three cases of anterior closing wedge osteotomy for the treatment of cervical hyperlordosis. The anterior vertebral column was exposed firstly, and C7–T1 closing wedge osteotomy was performed using the disc as a hinge.…”

Section: Discussionmentioning

confidence: 99%

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Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine

et al. 2019

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Background In patients with cervical ankylosis, the chin-brow vertical angle (CBVA) should be taken into consideration. Usually, the correction of sagittal balance is sacrificed to ensure the patient has a horizontal visual field. To our knowledge, a staged osteotomy strategy for ankylosing spondylitis kyphotic deformity with an ankylosed cervical spine has not been reported before. The aim of this study was to describe a new surgical strategy with emphasis on sagittal balance and gaze angle in correction of kyphotic deformity with a rigid cervical spine in ankylosing spondylitis thoracolumbar kyphotic deformity. Methods A 36-year-old man has severe thoracolumbar kyphosis accompanied with cervical hyperlordosis caused by ankylosing spondylitis. A two-stage surgery planning was managed. For the first stage, an interrupted two-level osteotomy was performed at the thoracolumbar area. After surgery, sagittal imbalance was corrected but the CBVA was − 21.7°. Cervical osteotomy was performed for the second stage. A flexion osteotomy was performed at C7, using anterior-posterior-anterior approaches. Results Both sagittal imbalance and gaze angle of the patient were improved markedly. The osteotomy sites were documented fused. Complications were not observed during and after operation. Conclusions The aim of osteotomy for ankylosing spondylitis is to reestablish sagittal balance and improve forward gaze and the visual field. A staged cervical osteotomy is an alternative to reduce cervical lordosis to obtain a normal gaze angle. An anterior-posterior-anterior approach is recommended.

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Section: Discussionmentioning

confidence: 99%

“…Sengupta et al [1] reported a case of flexion osteotomy of the cervical spine for correction of iatrogenic extension deformity in ankylosis. Kose et al [9] reported three cases of anterior closing wedge osteotomy for the treatment of cervical hyperlordosis.…”

Section: Introductionmentioning

confidence: 99%

Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine

et al. 2019

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“…Diebo et al 5 observed that the restoration of global sagittal alignment after the correction of cervical deformity in EDMD during 8-year follow-up. Coincidentally, Kose et al 7 reported similar clinical outcomes in Becker muscular dystrophy (BMD), wherein sagittal alignment was restored after correction of cervical deformity. They all considered that the cervical hyperlordosis could be the driver of global sagittal malalignment, and suggested that cervical deformity should be dealt with first.…”

Section: Pathological and Genetic Diagnosismentioning

confidence: 94%

“…11,12 Contracture of the cervical extensors, especially combined with contracture of paraspinal ligaments, can lead to cervical hyperextension. 3,11 Additionally, Kose et al 7 reported difficulty moving into the osteotomy line when they attempted to raise patient's head for closing the osteotomy line after anterior cervical osteotomy, because of existence of rigid posterior cervical soft tissue. Therefore, performing posterior surgery first for sufficient release of soft tissue may be a better option.…”

Section: Pathological and Genetic Diagnosismentioning

confidence: 99%

Surgical Treatment for Severe Cervical Hyperlordosis and Thoracolumar Kyphoscoliosis with Emery–Dreifuss Muscular Dystrophy: A Case Report and Literature Review

Tang

Qin

et al. 2022

Orthopaedic Surgery

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Background Emery–Dreifuss muscular dystrophy (EDMD) is an uncommon, gradually progressive X‐linked myopathy, and it could result in rigid spinal deformity. Only a few case reports have described surgical treatment of cervical hyperlordosis and thoracolumbar kyphoscoliosis secondary to EDMD. We report a rare case of EDMD to present the surgical strategies of severe cervical hyperlordosis and thoracolumbar kyphoscoliosis. Case presentation The patient was a 22‐year‐old man with EDMD who had severe cervical hyperlordosis and thoracolumbar kyphoscoliosis. A posterior spinal fusion from T9‐S2 was performed to correct the thoracolumbar kyphoscoliosis at the age of 21 years. Six months later, with an anterior C7‐T1 closing wedge bone‐disc‐bone osteotomy and a posterior–anterior–posterior cervicothoracic fusion from C4‐T4, the cervical deformity was corrected, thus achieving a horizontal gaze. During 1.5‐year follow‐up, no loss of correction was observed. Conclusion Cervical posterior–anterior–posterior closing‐wedge osteotomy combined with long fusion at thoracolumbar spine can be a reliable surgical technique to correct severe spine deformity in EDMD. This two‐stage revision surgical strategy can help restore a horizontal gaze on the basis of a balanced trunk. Cervical deformity in such patients should be corrected in the first stage considering its role as a “driver” of the global spine deformity.

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“…Kose et al . [14] reported that BDBO was performed at the C7-T1 level to correct an extension deformity of the cervical spine in patients with muscular dystrophy who presented clinically with debilitating hyperlordosis; the procedure resulted in significant acute clinical and radiological improvement.…”

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confidence: 99%

Osteotomy Techniques for Spinal Deformity

Wang

2016

Chinese Medical Journal

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C7–T1 Anterior Closing Wedge Bone-Disc-Bone Osteotomy for the Treatment of Cervical Hyperlordosis in Muscular Dystrophy

Abstract: 4.

Cited by 12 publications

References 13 publications

Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine

Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine

Surgical Treatment for Severe Cervical Hyperlordosis and Thoracolumar Kyphoscoliosis with Emery–Dreifuss Muscular Dystrophy: A Case Report and Literature Review

Osteotomy Techniques for Spinal Deformity

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