Cervical Kyphosis in Patients Who Have Larsen Syndrome* by CHARLES E. JOHNSTON, JOHN G. BIRCH, and JOHN L. DANIELS J Bone Joint Surg Am Volume 78(4):538-45.

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Presentation transcript:

Cervical Kyphosis in Patients Who Have Larsen Syndrome* by CHARLES E. JOHNSTON, JOHN G. BIRCH, and JOHN L. DANIELS J Bone Joint Surg Am Volume 78(4): April 1, 1996 ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-A, 1-B, and 1-C: The patient, first seen in 1977, who had cervical kyphosis but was not included in our series because the kyphosis was not treated until he was twelve years old, at which time he had severe myelopathy. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B: Lateral radiograph, made with the cervical spine in the neutral position when the patient was twelve years old, showing the kyphosis, which measured 48 degrees. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

T1-weighted magnetic resonance images showing severe impingement on the spinal cord. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A through 2-E: Case 1. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A and 2-B: Lateral radiographs, made when the patient was sixteen months old, showing progression of the kyphosis to 35 degrees (Fig. 2-A), with correction to 0 degrees in extension (Fig. 2-B). CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-C: Lateral radiograph, made two months after the posterior arthrodesis, showing correction of the kyphosis to 4 degrees with immobilization in a halo vest. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-D: Lateral radiograph, made six months postoperatively, showing a solid posterior fusion. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Lateral radiograph, made six years postoperatively, showing normal cervical lordosis (21 degrees), with apparent extension of the fusion to include the fourth to the seventh cervical vertebra. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A through 3-F: Case 4. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B: Lateral radiograph, made immediately after the posterior arthrodesis, showing the patient in the orthosis and correction of the kyphosis to 39 degrees. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

The first echo of a T2-weighted magnetic resonance imaging sequence that was made fifteen months postoperatively, showing severe impingement on the spinal cord. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-D: Lateral radiograph, made one week after a decompressive vertebrectomy of the fourth cervical vertebra and an anterior arthrodesis with tibial strut-grafting, showing the position in the halo vest. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-E: Lateral radiograph, made ten months postoperatively, showing non-union of the anterior fusion site with a dramatic increase in the kyphosis. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Lateral radiograph, made one year after the second anterior decompression and arthrodesis with strut-grafting from the second to the seventh cervical vertebra, showing a solid fusion. CHARLES E. JOHNSTON II et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.