Multilevel thoracic pedicle aplasia causing congenital thoracic kyphosis: case report.
OBJECTIVE
Congenital thoracic kyphosis is a rare cause of treatable myelopathy. Multilevel thoracic pedicle aplasia as a cause of this deformity has not been previously reported in the literature. We report a case and describe the surgical management and outcome.


METHODS
A 14-year-old boy presented to us with a 4-month history of back pain and slowly progressive spastic paraparesis. Radiographic studies revealed thoracic kyphosis and bilateral aplasia of the pedicles of T4-T8.


METHODS
The patient underwent surgical treatment via a posterior approach for decompression of T4-T8, followed by arthrodesis from T2 to T12, using a hook claw construct with multiple points of fixation and autologous bone grafting.


CONCLUSIONS
Congenital vertebral anomalies may be clinically occult, and delayed presentation may occur in adolescence or adulthood. Aplasia of multiple thoracic pedicles can produce kyphotic deformities with neurological compromise. A posterior approach with multiple points of segmental instrumentation can be effective in treating kyphotic deformities that are flexible and of moderate severity (<75 degrees).
Rauzzino
M J
MJ
Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Shaffrey
C I
CI
Bartkowski
H
H
Nockels
R
R
Wiggins
G
G
D000293:Adolescent; D016025:Bone Transplantation; D006801:Humans; D007738:Kyphosis / Q000151:congenital* / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D013902:Radiography, Thoracic; D013123:Spinal Fusion; D013896:Thoracic Diseases / Q000151:congenital* / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology