TITLE:
Successful Congenital Kyphoscoliosis (with Severe Truncal Shift) Correction Associated with Syrinx and Diastematomylia without Prior Neurosurgical Intervention: A Case Report and Brief Review of Literature
AUTHORS:
Raghad Mohammed Barri, Abdulmonem Mohammed Alsiddiky
KEYWORDS:
Scoliosis, Syrinx, Diastematomylia, Traction, Halo-Femoral Fixation
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.12 No.4,
April
25,
2022
ABSTRACT: Introduction and
Importance: The use of halo-femoral traction to ease
correction in patients with scoliosis with multiple intraspinal pathologies is
an evolving technique that is not yet fully understood.
This report aimed to demonstrate the efficiency of using this technique
to achieve maximum deformity correction
along with decreasing complication rates. Case Presentation: Congenital
scoliosis with two intraspinal pathologies was corrected in a 17-year-old male with severe truncal shift,
who was easily fatigued due to respiratory symptoms, utilizing the
traction method with no neurosurgical intervention. The patient had consulted
many hospitals locally and internationally, and was told that surgery poses a
great risk of neurological deficit. He needed neurosurgical release of the cord prior to any deformity
correction. Management and Outcome: The patient did not
undergo any neurosurgical intervention, but rather posterior spinal correction
and instrumented fusion preceded by halo-femoral traction. He was followed up
for 5 years and showed complete recovery without any short-term or long-term
complications. The patient was able to return to full activity and resolution
of respiratory symptoms, and a good alignment on follow-up radiography was
observed. Discussion: Not all patients with scoliosis associated with
intraspinal pathology need treatment before spinal correction. Perioperative
halo-femoral traction seems to be safe and effective in maximizing deformity
correction and decreasing the risk of complications.