Effect of decompressive surgery on spine balance in congenital lumbar kyphoscoliosis: anatomical aspect with a case report

Abstract

The lumbar vertebral column is a complex structure formed by the fusion of intervertebral joints. It protects the spinal cord by wrapping around it, carries most of the body’s weight and creates a flexible structure for the body. As individuals with congenital deformities of the lumbar vertebral column age, they develop some changes in the anatomy of the spine and with some consequences. In this case, a 35-year-old male patient had a deteriorated posture together with back pain since childhood. He had walking difficulty and numbness in two legs during walking for the last three years. He fell due to a sudden brake while he was travelling afoot by bus in 2015. He was admitted to the emergency service with loss of strength in two legs. Lumbar CT and MRI showed a severe narrowing of the spinal canal due to lumbar kyphoscoliosis. The patient had neurological deficits after hyperflexion trauma. The patient underwent emergency decompressive surgery due to marked paraparesis and narrow spinal canal. At the end of the first post-operative month, his clinical complaints were almost completely resolved, and his biomechanical balance did not show radiological deterioration. While the anatomical change that occurred during the natural course of congenital kyphoscoliosis increased the stability of the lumbar spine, it severely narrowed the spinal canal and affected the spinal nerves and thereby caused severe neurological deficits.