Surgical treatment of advanced congenital kyphoscoliosis: A case report

Abstract

Clinical case of surgical treatment of advanced congenital kyphoscoliosis in 12 years old child is reported. Radiographs and CT at presentation failed to reveal the entire anomaly. By analysis of priorly made radiographs hemivertebra L1 was recognized. At genitourinary assessment L-shaped kidney was detected. A full-size 3D-printed model was used for surgical planning. Vertebral column resection as treatment option was discussed, but due to high neurologic complication rate this approach was refused. After preoperative 35 days halo-femoral traction anterior instrumented fusion was performed. Right ureter was stented for intraoperative urologic injury prevention. Scoliosis correction of 32% and kyphosis of 14% was achieved. 5 months later definitive posterior uninstrumented fusion was performed. Spinal deformities caused by vertebral malformations progress dramatically unless they are treated early. An advanced case is a clinical challenge because of technical difficulties and poor result. Vertebral column resection is a treatment option for severe kyphoscoliosis, but it’s indications should be strictly individualized. Preoperative halo-femoral traction is the most safe correction method in spinal deformity due to prolonged and gradual action. 3d-printed models are practical for surgical planning. The model may be used intraoperatively as a 3D-reference. In congenital scoliosis genitourinary system should be assessed meticulously, and urologist advice in relevant case is necessary.

A New Three-Dimensional (3D) Printing Prepress Algorithm for Simulation of Planned Surgery for Congenital Heart Disease

“…It has become an increasingly popular tool that contributes to rapid technological progress. Along with the increasing availability of 3D printing, this tool has also begun to be used in medical practice to improve methods of surgical repair for various pathologies [1,2]. Current technologies allow professionals to obtain virtual 3D reconstructions of any part of the body to acquire an accurate image of a pathology, organ arrangement, and tumor localization [2,3].…”

“…Along with the increasing availability of 3D printing, this tool has also begun to be used in medical practice to improve methods of surgical repair for various pathologies [1,2]. Current technologies allow professionals to obtain virtual 3D reconstructions of any part of the body to acquire an accurate image of a pathology, organ arrangement, and tumor localization [2,3]. At the moment, most of the studies on the use of 3D printing in medicine belong to reconstructive, cancer, and maxillofacial surgery [4][5][6][7][8][9][10][11].…”