Long-term management of congenital lordoscoliosis of the thoracic Spine

Purpose The objective of this study is to report the progression of congenital hyperlordoscoliosis in a 2-year-old patient and the use of multiple surgical interventions in the treatment of hyperlordoscoliosis of the thoracic spine. Methods A 2-year-old patient with thoracic hyperlordosis underwent observation for 1 year. To halt the progression of hyperlordosis, a posterior laminectomy was carried out to remove all the fused segments. Despite surgery, lordosis progressed via spontaneous autofusion with development of scoliosis with unilateral unsegmented bar. At the age of 9 years, the patient underwent posterior osteotomy at the fused segments, which was unsuccessful in the correction of hyperlordosis, but was successful in the correction of scoliosis. At the age of 12 years, the patient complained of mild breathing difficulties resulting from hyperlordosis of the thoracic spine, and underwent posterior multilevel vertebral osteotomy (PMVO) again to correct lordoscoliosis. Results Follow-up in the 3 years after PMVO showed that correction of the deformity was well maintained, with a good clinical outcome and a well-balanced spine. Conclusions PMVO is a potential intervention to manage rigid and severe congenital lordoscoliosis of the thoracic spine.