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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(01): 155-158
DOI: 10.4103/ajns.AJNS_195_20
Case Report

Surgical management of pediatric cervical angular kyphosis with 540° approach and metacarpal plate: A case report and introduction of a novel technique

Mohammad Zarei
Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran
,
Mersad Moosavi
1   Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran
,
Nima Rahimi
2   Department of Neurosurgery, Tehran University of Medical Sciences, Tehran
,
Mohsen Rostami
3   Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran
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Surgical decompression, deformity correction, and instrumentation of the upper cervical spine are challenging problems in cervical kyphosis, especially in infants and pediatrics. According to patients' age, surgical exposure is difficult and selecting the appropriate instrument for rigid fixation is crucial. In this article, we present a case of 2 years old with cervical angular kyphosis, which was approached posteriorly at first. Through posterior approach, C3–C5 laminectomy with complete excision of spinous process was performed. Then, the patient's position was changed to supine and C3–C5 corpectomies were performed anteriorly with a longitudinal incision, and the thecal sac was decompressed. A titanium cage with appropriate size and graft was placed after possible deformity correction conducted with head traction and neck extension. Anterior fixation was performed with two, 2-mm T-shaped metacarpal plates with two screws in C2 and four screws in C6. The patient's position was changed to prone again, and posterior fixation was done with two metacarpal plates located on lateral masses. We showed that a novel technique in correction and fixation of cervical kyphosis in pediatric is using metacarpal plates while they are fixed to lateral masses.

Key-words:

Cervical fusion - cervical kyphosis - pediatric spine

Financial support and sponsorship

Nil.




Publication History

Received: 03 May 2020

Accepted: 20 October 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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