Reshaping the boy’s nearly 90-degree curvature

Ho Chi Minh CityThe 26-year-old boy bent his spine nearly 90 degrees, could not see straight ahead, had difficulty walking, after a year of falling and hitting his back on the ground due to a traffic accident.

In the past year, he did not go to the hospital for examination, but bought medicine by himself, his condition was getting worse, greatly affecting his daily life and communication. In early November, he visited the Ho Chi Minh City Hospital of Trauma and Orthopedics. The patient was diagnosed with ankylosing spondylitis 9 years ago.

Dr. Nguyen Trong Tin (Head of Spine Department B, Ho Chi Minh City Hospital of Trauma and Orthopedics) said that the imaging results showed that the patient had a dislocated vertebrae, on the background of spondyloarthritis. The doctors decided to surgically clean the fracture, correct the cuffs and fix the spine.

The surgery was successful after 5 hours, blood loss was about 1.2 liters. Immediately after surgery, the patient was able to lie on his back because the spine was straightened. He started to sit up on the third day and walked on the 5th day. The post-operative X-ray showed that the doctor had adjusted. more than 60 degrees of the original cuff angle, restoring the patient’s upright posture.

The patient before surgery (left) with nearly 90 degrees of curvature of the spine and after surgery (right) with the spine straightened and restored to 66 degrees of curvature. Photo: Ho Chi Minh City Hospital of Trauma and Orthopedics

According to Dr. Tin, this is a complicated case of spinal curvature, due to an old fracture that does not heal on the background of ankylosing spondylitis. The patient’s cuff angle is large, so the chiropractor must operate very gently and carefully to avoid nerve damage.

“In this patient, we applied a new method of chiseling an improved bow with a configuration of four longitudinal bars, instead of two vertical bars as before. The addition of two additional vertical bars enhances stability and the ability to adjust the configuration, helping to promote bone healing, “doctor Tin shared.

From the beginning of last year to now, Department of Spine B has applied the new technique on 4 patients, of which three are severely cuffed due to ankylosing spondylitis. The results of all four patients improved well, in which this case was the surgery with the highest degree of correction.

X-ray of the patient's spine before surgery (left), images of the planned correction by computer software (middle image) and the patient's post-operative reality (right)

X-ray image of the patient’s spine before surgery (left), image of planned correction by computer software (middle image) and actual postoperative image of the patient (right). Photo: Ho Chi Minh City Hospital of Trauma and Orthopedics

Doctor Vu Tam Truc, a member of the surgical team, said that with this patient, if the manipulation is not enough or too much, it can cause loss of balance after surgery. The team planned the surgery in detail using specialized computer software, helping to determine the optimal location of the osteosarcoma and the optimal degree of osteosarcoma, predicting the shape of the spine after surgery so that the surgeon can adjust it. adjustment strategy accordingly.

Le Phuong