Asymmetrical pedicle subtraction osteotomy for progressive kyphoscoliosis caused by a pediatric Chance fracture

A case report

Satoshi Suzuki, Nobuyuki Fujita, Tomohiro Hikata, Akio Iwanami, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Koota Watanabe

Research output: Contribution to journalArticle

Abstract

Background: Although most pediatric Chance fractures (PCFs) can be treated successfully with casting and bracing, some PCFs cause progressive spinal deformities requiring surgical treatment. There are only few reports of asymmetrical osteotomy for PCF-associated spinal deformities. Case presentation: We here report a case of a 10-year-old girl who suffered an L2 Chance fracture from an asymmetrical flexion-distraction force, accompanied by abdominal injuries. She was treated conservatively with a soft brace. However, a progressive spinal deformity became evident, and 10 months after the injury, examination showed segmental kyphoscoliosis with a Cobb angle of 36°, a kyphosis angle of 31°, and a coronal imbalance of 30 mm. Both the coronal and sagittal deformities were successfully corrected by asymmetrical pedicle subtraction osteotomy. Conclusions: Initial kyphosis and posterior ligament complex should be evaluated at some point when treating PCFs. Asymmetrical pedicle subtraction osteotomy can be a useful surgical option when treating rigid kyphoscoliosis associated with a PCF.

Original languageEnglish
Article number8
JournalScoliosis and Spinal Disorders
Volume12
Issue number1
DOIs
Publication statusPublished - 2017 Mar 14

Fingerprint

Osteotomy
Pediatrics
Kyphosis
Spinal Fractures
Abdominal Injuries
Braces
Ligaments
Wounds and Injuries
Therapeutics

Keywords

  • Asymmetrical pedicle subtraction osteotomy
  • Case report
  • Chance fracture
  • Flexion-distraction injury
  • Kyphoscoliosis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Asymmetrical pedicle subtraction osteotomy for progressive kyphoscoliosis caused by a pediatric Chance fracture : A case report. / Suzuki, Satoshi; Fujita, Nobuyuki; Hikata, Tomohiro; Iwanami, Akio; Ishii, Ken; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Koota.

In: Scoliosis and Spinal Disorders, Vol. 12, No. 1, 8, 14.03.2017.

Research output: Contribution to journalArticle

@article{ab39b11aab5f432ea8f092ae4cb2fcc0,
title = "Asymmetrical pedicle subtraction osteotomy for progressive kyphoscoliosis caused by a pediatric Chance fracture: A case report",
abstract = "Background: Although most pediatric Chance fractures (PCFs) can be treated successfully with casting and bracing, some PCFs cause progressive spinal deformities requiring surgical treatment. There are only few reports of asymmetrical osteotomy for PCF-associated spinal deformities. Case presentation: We here report a case of a 10-year-old girl who suffered an L2 Chance fracture from an asymmetrical flexion-distraction force, accompanied by abdominal injuries. She was treated conservatively with a soft brace. However, a progressive spinal deformity became evident, and 10 months after the injury, examination showed segmental kyphoscoliosis with a Cobb angle of 36°, a kyphosis angle of 31°, and a coronal imbalance of 30 mm. Both the coronal and sagittal deformities were successfully corrected by asymmetrical pedicle subtraction osteotomy. Conclusions: Initial kyphosis and posterior ligament complex should be evaluated at some point when treating PCFs. Asymmetrical pedicle subtraction osteotomy can be a useful surgical option when treating rigid kyphoscoliosis associated with a PCF.",
keywords = "Asymmetrical pedicle subtraction osteotomy, Case report, Chance fracture, Flexion-distraction injury, Kyphoscoliosis",
author = "Satoshi Suzuki and Nobuyuki Fujita and Tomohiro Hikata and Akio Iwanami and Ken Ishii and Masaya Nakamura and Morio Matsumoto and Koota Watanabe",
year = "2017",
month = "3",
day = "14",
doi = "10.1186/s13013-017-0115-1",
language = "English",
volume = "12",
journal = "Scoliosis and Spinal Disorders",
issn = "1748-7161",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Asymmetrical pedicle subtraction osteotomy for progressive kyphoscoliosis caused by a pediatric Chance fracture

T2 - A case report

AU - Suzuki, Satoshi

AU - Fujita, Nobuyuki

AU - Hikata, Tomohiro

AU - Iwanami, Akio

AU - Ishii, Ken

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Koota

PY - 2017/3/14

Y1 - 2017/3/14

N2 - Background: Although most pediatric Chance fractures (PCFs) can be treated successfully with casting and bracing, some PCFs cause progressive spinal deformities requiring surgical treatment. There are only few reports of asymmetrical osteotomy for PCF-associated spinal deformities. Case presentation: We here report a case of a 10-year-old girl who suffered an L2 Chance fracture from an asymmetrical flexion-distraction force, accompanied by abdominal injuries. She was treated conservatively with a soft brace. However, a progressive spinal deformity became evident, and 10 months after the injury, examination showed segmental kyphoscoliosis with a Cobb angle of 36°, a kyphosis angle of 31°, and a coronal imbalance of 30 mm. Both the coronal and sagittal deformities were successfully corrected by asymmetrical pedicle subtraction osteotomy. Conclusions: Initial kyphosis and posterior ligament complex should be evaluated at some point when treating PCFs. Asymmetrical pedicle subtraction osteotomy can be a useful surgical option when treating rigid kyphoscoliosis associated with a PCF.

AB - Background: Although most pediatric Chance fractures (PCFs) can be treated successfully with casting and bracing, some PCFs cause progressive spinal deformities requiring surgical treatment. There are only few reports of asymmetrical osteotomy for PCF-associated spinal deformities. Case presentation: We here report a case of a 10-year-old girl who suffered an L2 Chance fracture from an asymmetrical flexion-distraction force, accompanied by abdominal injuries. She was treated conservatively with a soft brace. However, a progressive spinal deformity became evident, and 10 months after the injury, examination showed segmental kyphoscoliosis with a Cobb angle of 36°, a kyphosis angle of 31°, and a coronal imbalance of 30 mm. Both the coronal and sagittal deformities were successfully corrected by asymmetrical pedicle subtraction osteotomy. Conclusions: Initial kyphosis and posterior ligament complex should be evaluated at some point when treating PCFs. Asymmetrical pedicle subtraction osteotomy can be a useful surgical option when treating rigid kyphoscoliosis associated with a PCF.

KW - Asymmetrical pedicle subtraction osteotomy

KW - Case report

KW - Chance fracture

KW - Flexion-distraction injury

KW - Kyphoscoliosis

UR - http://www.scopus.com/inward/record.url?scp=85021683289&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021683289&partnerID=8YFLogxK

U2 - 10.1186/s13013-017-0115-1

DO - 10.1186/s13013-017-0115-1

M3 - Article

VL - 12

JO - Scoliosis and Spinal Disorders

JF - Scoliosis and Spinal Disorders

SN - 1748-7161

IS - 1

M1 - 8

ER -