Dr Vikas Tandon, Consultant Spine Surgeon, from Indian Spinal Injuries Centre, Delhi recently treated a three-year-old girl child, Zoya, from Kota (Rajasthan), who had a deformity on the lower back and was walking with a stooped posture with bent knees. She was found to have a condition called Spondyloptosis of L5 over S1. This is a congenital deformity with a defect in the vertebrae and thus leading to slippage of one vertebra over the other. It is known as a high dysplastic spondylolisthesis.
After a lot of surgical planning the child was operated and the listhesis (slipped vertebra) was reduced back successfully back by Dr Tandon. The surgery which took about five hours, was done from behind and the spine exposed. Pedicle screws were inserted from L3 to S2 with reduction screws in L5. After thorough decompression of the roots (especially of L5 which is at danger while reducing such deformities), only screw of L5 and S1 were locked and others were not locked so as to allow growth of the girl and posterolateral grafting was done only between L5 and S1 with no interbody fusion.
 |
 |
 |
There have been reports in the medical literature (throughout the world) of the treatment of such cases but all these cases have been reported in children who are 10 years and beyond. This is a special case when this high grade variety has been noticed in a three-year-old child. This also poses problems in surgical planning as usually these patients need surgery for correction of there deformity which require instrumentation.
Since this is a three-year-old child, the bony structures are very small for the implants to hold. Second fusion which is an accepted method of treatment in such patients is another point to ponder upon keeping in mind the growth which is still to come in this case.
Post operatively the child was neurologically normal and was made to walk two days after the surgery and was walking straighter.
- Advertisement -
