We discuss a unique approach to a patient who presented with severe kyphosis and laterolisthesis of the cranio-cervico-thoracic spine, following a history of neck trauma 24 months prior to presentation. The patient had organized voluntary euthanasia if no treatment could be performed. Our approach included a three-part procedure over a 3-week time interval, including: initial traction, division of anterior neck muscles, multilevel anterior fusion and, finally, posterior occipito-cervico-thoracic fusion. Follow-up at 6 months revealed a patient in neutral sagittal and coronal balance of the neck.
Department of Neurosurgery, Prince of Wales Hospital, Barker St, Randwick New South Wales 2031, Australia
Cervico-thoracic kyphosis can develop in association with degenerative processes, systemic disease (ankylosing spondylitis, rheumatoid arthritis), tumour, congenital disorders, post-surgery, and after traumatic injury.1 The kyphosis can be functionally and emotionally debilitating in terms of pain and progressive neurological deficit, and when severe can present a difficult challenge for surgical correction. We report a female patient with a severe fixed deformity who was treated using a multi-level multi-stage approach.
Cervical deformity Kyphosis Occipito-cervico-thoracic fusion Reconstructive surgery
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