Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis

A 26-year-old paraplegic schizophrenic Japanese woman suffered from severe kyphosis and back pain derived from lumbar burst fractures caused by jumping. She had already undergone resection of the L1 and L2 spinous processes for sharp angular kyphosis, but she still had severe kyphosis and back pain...

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Main Authors: Atsuro Yamazaki, Sumihisa Orita, Takeshi Sainoh, Kazuyo Yamauchi, Miyako Suzuki, Yoshihiro Sakuma, Go Kubota, Yasuhiro Oikawa, Kazuhide Inage, Yukio Nakata, Gen Inoue, Yasuchika Aoki, Tomoaki Toyone, Junichi Nakamura, Masayuki Miyagi, Kazuhisa Takahashi, Seiji Ohtori
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2013/614757
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author Atsuro Yamazaki
Sumihisa Orita
Takeshi Sainoh
Kazuyo Yamauchi
Miyako Suzuki
Yoshihiro Sakuma
Go Kubota
Yasuhiro Oikawa
Kazuhide Inage
Yukio Nakata
Gen Inoue
Yasuchika Aoki
Tomoaki Toyone
Junichi Nakamura
Masayuki Miyagi
Kazuhisa Takahashi
Seiji Ohtori
author_facet Atsuro Yamazaki
Sumihisa Orita
Takeshi Sainoh
Kazuyo Yamauchi
Miyako Suzuki
Yoshihiro Sakuma
Go Kubota
Yasuhiro Oikawa
Kazuhide Inage
Yukio Nakata
Gen Inoue
Yasuchika Aoki
Tomoaki Toyone
Junichi Nakamura
Masayuki Miyagi
Kazuhisa Takahashi
Seiji Ohtori
author_sort Atsuro Yamazaki
collection DOAJ
description A 26-year-old paraplegic schizophrenic Japanese woman suffered from severe kyphosis and back pain derived from lumbar burst fractures caused by jumping. She had already undergone resection of the L1 and L2 spinous processes for sharp angular kyphosis, but she still had severe kyphosis and back pain at the L1 and L2. Radiographical examination revealed fused anterior columns at L1 and L2 with severe local kyphosis and a significantly decreased percutaneous distance in the back. The patient underwent anterior instrumented bony resection including an L2 vertebral osteotomy: bilateral L2-L3 facetectomy and partial posterior osteotomy of the L2 vertebrae via a posterior approach followed by an anterior corpectomy of the L2 vertebrae and insertion of a cylindrical cage. No posterior instrumentation was used owing to the presence of atrophied paraspinal soft tissues. Lumbar interbody fusion was performed with vertebral body screws extending from T12 to L4 and corresponding anterior distension and posterior compression. The procedure corrected the kyphosis by 15° and enhanced local stability. Postsurgical visual analogue scale improved from 9.0 to 2.0 and Oswestry Disability Index from 40 to 17.8, respectively. In conclusion, we have demonstrated that anterolateral interbody fusion using extended fixation can compensate for posterior corrective surgery.
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spelling doaj-art-fe4e14b165e74ff6b5a65330818c00fc2025-08-20T03:25:45ZengWileyCase Reports in Orthopedics2090-67492090-67572013-01-01201310.1155/2013/614757614757Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic KyphosisAtsuro Yamazaki0Sumihisa Orita1Takeshi Sainoh2Kazuyo Yamauchi3Miyako Suzuki4Yoshihiro Sakuma5Go Kubota6Yasuhiro Oikawa7Kazuhide Inage8Yukio Nakata9Gen Inoue10Yasuchika Aoki11Tomoaki Toyone12Junichi Nakamura13Masayuki Miyagi14Kazuhisa Takahashi15Seiji Ohtori16Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, JapanA 26-year-old paraplegic schizophrenic Japanese woman suffered from severe kyphosis and back pain derived from lumbar burst fractures caused by jumping. She had already undergone resection of the L1 and L2 spinous processes for sharp angular kyphosis, but she still had severe kyphosis and back pain at the L1 and L2. Radiographical examination revealed fused anterior columns at L1 and L2 with severe local kyphosis and a significantly decreased percutaneous distance in the back. The patient underwent anterior instrumented bony resection including an L2 vertebral osteotomy: bilateral L2-L3 facetectomy and partial posterior osteotomy of the L2 vertebrae via a posterior approach followed by an anterior corpectomy of the L2 vertebrae and insertion of a cylindrical cage. No posterior instrumentation was used owing to the presence of atrophied paraspinal soft tissues. Lumbar interbody fusion was performed with vertebral body screws extending from T12 to L4 and corresponding anterior distension and posterior compression. The procedure corrected the kyphosis by 15° and enhanced local stability. Postsurgical visual analogue scale improved from 9.0 to 2.0 and Oswestry Disability Index from 40 to 17.8, respectively. In conclusion, we have demonstrated that anterolateral interbody fusion using extended fixation can compensate for posterior corrective surgery.http://dx.doi.org/10.1155/2013/614757
spellingShingle Atsuro Yamazaki
Sumihisa Orita
Takeshi Sainoh
Kazuyo Yamauchi
Miyako Suzuki
Yoshihiro Sakuma
Go Kubota
Yasuhiro Oikawa
Kazuhide Inage
Yukio Nakata
Gen Inoue
Yasuchika Aoki
Tomoaki Toyone
Junichi Nakamura
Masayuki Miyagi
Kazuhisa Takahashi
Seiji Ohtori
Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis
Case Reports in Orthopedics
title Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis
title_full Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis
title_fullStr Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis
title_full_unstemmed Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis
title_short Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis
title_sort anterolateral corrective lumbar corpectomy and interbody fusion by using extended screw fixation without posterior instrumentation for posttraumatic kyphosis
url http://dx.doi.org/10.1155/2013/614757
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