Abstract：
The purpose of this study is to present a case report of a patient with bilateral upper extremity phocomelia with progressive scoliosis, who underwent vertebral body tethering (VBT).
This is a case report on the use of VBT in a patient with scoliosis and bilateral congenital phocomelia, with 5 year follow-up.
A male patient with bilateral phocomelia had early onset scoliosis that progressed to 45° at age 10. Surgical options were discussed, including traditional VBT, posterior spinal fusion, growing rods, magnetically controlled growing rods, and vertical expandible prosthetic titanium ribs. These options would limit the flexibility of the spine. Given these pitfalls, VBT was chosen, as it would address the scoliosis while maintaining trunk flexibility. Preoperatively, he had 45° right main thoracic curve, bending to 22°; he was Risser 0 with open triradiate cartilage. He underwent T6-T11 thoracoscopic VBT, with postoperative correction to 37°. Postoperatively, the patient was able to continue to use his lower extremities for writing, feeding, and personal grooming. He had no postoperative complications. At 3 years, his curve was 21°, and at 5 years was 19°.
This case describes a novel technique for treating scoliosis in patients with bilateral phocomelia. Other forms of scoliosis surgical treatment limit motion of the spine. Due to this, we present VBT as an option for this unique set of patients for correcting scoliosis, while also preserving trunk flexibility for its role in feeding and self-care.
This is a case report on the use of VBT in a patient with scoliosis and bilateral congenital phocomelia, with 5 year follow-up.
A male patient with bilateral phocomelia had early onset scoliosis that progressed to 45° at age 10. Surgical options were discussed, including traditional VBT, posterior spinal fusion, growing rods, magnetically controlled growing rods, and vertical expandible prosthetic titanium ribs. These options would limit the flexibility of the spine. Given these pitfalls, VBT was chosen, as it would address the scoliosis while maintaining trunk flexibility. Preoperatively, he had 45° right main thoracic curve, bending to 22°; he was Risser 0 with open triradiate cartilage. He underwent T6-T11 thoracoscopic VBT, with postoperative correction to 37°. Postoperatively, the patient was able to continue to use his lower extremities for writing, feeding, and personal grooming. He had no postoperative complications. At 3 years, his curve was 21°, and at 5 years was 19°.
This case describes a novel technique for treating scoliosis in patients with bilateral phocomelia. Other forms of scoliosis surgical treatment limit motion of the spine. Due to this, we present VBT as an option for this unique set of patients for correcting scoliosis, while also preserving trunk flexibility for its role in feeding and self-care.
摘要：
目的：本研究的目的是提供一例双侧上肢骨折伴进行性脊柱侧凸的病例报告，接受椎体束缚（VBT）的患者。
方法：这是一例关于在脊柱侧凸和双侧先天性白内障患者中使用VBT的病例报告，5年随访。
结果：一名男性患者患有双侧phocomelia，在10岁时发展到45°的早发性脊柱侧凸。讨论了手术选择，包括传统的VBT,后路脊柱融合术,生长棒，磁控生长棒，和垂直可膨胀的假体钛肋骨。这些选项将限制脊柱的灵活性。鉴于这些陷阱，VBT被选中,因为它可以解决脊柱侧弯，同时保持躯干的灵活性。术前,他有45°的右主胸曲线，弯曲至22°；他是Risser0，三辐射软骨开放。他接受了T6-T11胸腔镜VBT,术后矫正至37°。术后,患者能够继续使用下肢书写，喂养,和个人修饰。他没有术后并发症。三年后，他的曲线是21°,5岁时是19°。
结论：本病例描述了一种新的技术，用于治疗双侧远视患者的脊柱侧凸。其他形式的脊柱侧凸手术治疗限制了脊柱的运动。由于这个原因,我们提出了VBT作为纠正脊柱侧凸的独特患者的选择，同时还保持躯干的灵活性，因为它在喂养和自我保健方面的作用。
方法：这是一例关于在脊柱侧凸和双侧先天性白内障患者中使用VBT的病例报告，5年随访。
结果：一名男性患者患有双侧phocomelia，在10岁时发展到45°的早发性脊柱侧凸。讨论了手术选择，包括传统的VBT,后路脊柱融合术,生长棒，磁控生长棒，和垂直可膨胀的假体钛肋骨。这些选项将限制脊柱的灵活性。鉴于这些陷阱，VBT被选中,因为它可以解决脊柱侧弯，同时保持躯干的灵活性。术前,他有45°的右主胸曲线，弯曲至22°；他是Risser0，三辐射软骨开放。他接受了T6-T11胸腔镜VBT,术后矫正至37°。术后,患者能够继续使用下肢书写，喂养,和个人修饰。他没有术后并发症。三年后，他的曲线是21°,5岁时是19°。
结论：本病例描述了一种新的技术，用于治疗双侧远视患者的脊柱侧凸。其他形式的脊柱侧凸手术治疗限制了脊柱的运动。由于这个原因,我们提出了VBT作为纠正脊柱侧凸的独特患者的选择，同时还保持躯干的灵活性，因为它在喂养和自我保健方面的作用。
