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Surgical Management of Idiopathic Acute Cervical Kyphosis; a Case-Based Review of an Extremely Rare Entity Publisher



Javadi SAH1, 2 ; Eraghi MM1, 2, 3 ; Iranmehr A5 ; Khan ZH6 ; Rahimizadeh A7
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Student Research Committee, School of Medicine, Islamic Azad University, Qeshm International Branch, Qeshm, Iran
  4. 4. School of Medicine, Islamic Azad University, Qeshm International Branch, Qeshm, Iran
  5. 5. Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Anesthesiology and Critical Care, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran

Source: International Journal of Surgery Case Reports Published:2024


Abstract

Introduction and importance: Acute idiopathic cervical kyphosis (AICK) represents a rare entity, and its management remains controversial. Preoperative surgical planning and individual decision-making seem necessary. To date, there is a lack of sufficient evidence and clear guidelines. Case presentation: A 21-year-old male was referred with a progressive cervical deformity detected 3 months earlier. The patient suffered from severe progressive myelopathy and represented neither neck trauma nor a familial history of similar expected conditions. His cervical imaging revealed 95 degrees of cervical kyphosis. After 3 separate surgical sessions for 360-degree fixation, the cervical kyphosis was reduced by 90 degrees. No facet dislocation was observed, and laminectomy was unnecessary. Post-operative neurological examination detected significant improvement. Six months and 2-year follow-ups were favorable. To the authors' knowledge, the current case had the most extensive degree of cervical kyphosis reported in the literature. Clinical discussion: Multistage correction of AICK would result in a favorable outcome and reduce the risk of complications. Particular attention should be paid to the wide inter-spinous spaces in high grades of kyphosis during sub-periosteal dissection to prevent iatrogenic spinal cord injuries. Conclusion: The present work may provide the first report on the role of cervical postural habits in patients with opiate substance abuse disorder, which could have triggered cervical kyphosis in this particular patient. Multistage correction of AICK would result in a favorable outcome and reduce the risk of complications. © 2024 The Authors