Asymmetric C7 pedicle subtraction osteotomy for correction of rigid cervical coronal imbalance secondary to post-traumatic heterotopic ossification: a case report, description of a novel surgical technique, and literature review

作者：Theologis Alexander A^*; Bellevue Kate D; Qamirani Erion; Ames Christopher P; Deviren Vedat

来源：European Spine Journal, 2017, 26(1): S141-S145.

DOI：10.1007/s00586-016-4931-4

• Coronal imbalance
• Cervical deformity
• Pedicle subtraction osteotomy
• Heterotopic ossification

Purpose Deformities of the cervical spine are uncommon in the coronal plane. In this report, a unique case of a 31-year-old male with a fixed, 30 degrees left coronal deformity due to heterotopic ossification 3 years status post polytrauma was treated with an asymmetric C7 pedicle subtraction osteotomy (PSO).
Methods Case report.
Results Pre-operatively, the patient had a fixed 45-degree left tilt of his neck and radiographs demonstrated a rigid 30 degrees scoliosis, 7 cm coronal imbalance, and 4 cm negative sagittal balance, diffuse bridging bone between the spinous processes and the facet joints of C5 to T1 bilaterally. An asymmetric C7 PSO with C2-T3 posterior spinal fusion was completed without complication. There was residual 9 degrees coronal deformity, 2.9 cm left coronal imbalance, and 2.3 cm sagittal imbalance. He had a marked improvement in his function, as assessed by the SF-36 physical component score (pre-op 31.1; post-op 44.7) and mental component score (pre-op 46.0; post-op 66.8). Post-operatively, neck disability index scores also improved (pre-op 38; post-op 16). Although the patient passed away from a drug overdose 14 months post-operatively, he did not report neck pain, he had not sought evaluation from another physician for his neck, and he had not undergone a subsequent neck operation before his passing.
Conclusion In this one patient, an asymmetric C7 PSO was performed safely. While it was effective in addressing a fixed cervical coronal imbalance, its efficacy and safety profile should be confirmed in larger cohorts.

• 出版日期2017-5