[Thoracic spine pseudarthrosis treated by transpleural corporectomy and bone morphogenic protein].
OBJECTIVE
Traumatic thoracic spine instability is a rare but difficult-to-treat entity, particularly above T5 where pedicle screwing is widely regarded as an unsatisfactory option and anterior surgery is considered difficult because of the anatomic relationship with the shoulder and large vessels.


METHODS
A case of T4 and T5 pseudarthrosis after posterior fixation is reported. It was treated with transpleural corpectomy and fixation, with bone morphogenic protein used to obtain rapid arthrodesis between T3 and T6. No bracing or second posterior fixation was used.


RESULTS
At 45 days of follow-up, the patient was without pain and the neurologic examination was normal. The CT scan showed bony bridges across all fracture lines. Complete cure of this pseudarthrosis was achieved with a single surgery. At the 12-month follow-up, the clinical status was normal.


CONCLUSIONS
The use of bone morphogenic proteins might be of great help in rare but challenging cases of spinal pseudarthrosis, with a quick return to normal activity after a single-stage surgery.
Service de neurochirurgie, CHU Jean-Minjoz, 3 boulevard Alexander-Fleming, Besançon cedex, France. rbgrbg@free.fr
R
R
Billon-Grand
A
A
Petit
O
O
Launay
A
A
Czorny
D001174:Arthrodesis; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D007593:Joint Instability / Q000188:drug therapy* / Q000601:surgery*; D009460:Neurologic Examination; D019635:Neurosurgical Procedures; D011994:Recombinant Proteins / Q000627:therapeutic use; D012086:Reoperation; D013122:Spinal Diseases / Q000188:drug therapy* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins