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Rare congenital bony deformity shows improvement with surgery
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In a recently published article, researchers described two cases in which patients who presented with dorsal, midline hemivertebrae causing stretching of the nerve roots over a fixed kyphosis were treated surgically and demonstrated improvement in their abilities to sit and lay flat.
The congenital bony deformity is rare and, according to the researchers, has not been described previous to this study.
One male and one female patient presented with urinary hesitancy/incontinence, difficulty sitting, back and leg pain, and difficulty sitting and lying down. Both presented with a waddling gait and had restriction of movement, as well, according to the researchers. Through the use of imaging, it was determined both patients had a dorsally located midline hemivertebrae.
The researchers noted the surgical approach to each patient was similar, involving the resection of the hemivertebrae, with posterolateral instrumented fusion ranging from the L-2 region to the pelvis. Additionally, the female patient underwent sectioning of the filum terminale as a result of a low-lying conus.
Following surgery, both patients saw improvement in bladder and bowel function. The female patient had less disability, with full function and minimal residual pain, whereas the male patient reported improvements in his ability to walk, sit and lay flat; however, the male patient still had significant back and leg pain, according to the researchers. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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