Pediatric iatrogenic thoracic kyphosis and tension myelopathy treated with a thoracic pedicle subtraction osteotomy: a case report and review of the literature

Childs Nerv Syst. 2014 Jul;30(7):1293-9. doi: 10.1007/s00381-014-2373-z. Epub 2014 Feb 7.

Abstract

Purpose: Pediatric kyphotic deformity is an uncommon clinical entity that can occur following posterior spinal operations and has significant complexity in its treatment. Tension myelopathy in a pediatric patient with a thoracic kyphotic deformity has not been reported in the literature.

Case report: We present a 17-year-old boy with a progressive thoracic kyphosis and tension myelopathy 4 years after he underwent a thoracic laminoplasty at an outside institution for the treatment of a dorsal spinal arachnoid cyst. At our institution, he was treated with a pedicle subtraction osteotomy as well as thoracic Ponte osteotomies for sagittal plane correction to relieve the tension myelopathy.

Conclusions: Both clinical and radiographic improvements were observed after surgery. We review the literature on pediatric thoracic kyphosis and tension myelopathy and the treatment of these pathologies.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Arachnoid Cysts / surgery
  • Humans
  • Iatrogenic Disease*
  • Kyphosis / etiology
  • Kyphosis / surgery*
  • Laminoplasty / adverse effects*
  • Male
  • Osteotomy / methods*
  • Spinal Cord Diseases / etiology
  • Spinal Cord Diseases / surgery*
  • Thoracic Vertebrae

Supplementary concepts

  • Spinal intradural arachnoid cysts