A case report of severe kyphoscoliosis and autofusion of the posterior elements in two siblings with central core disease

[Research progress of spontaneous facet fusion after lumbar spine surgery]

OBJECTIVE

To summarize the research progress on spontaneous facet fusion (SFF) after lumbar spine surgery, and provide reference for further research on SFF.

METHODS

The definition, development, clinical significance, and related influence factors of SFF were throughout reviewed by referring to relevant domestic and foreign literature in recent years.

RESULTS

SFF is a phenomenon of joint space disappearance and fusion of upper and lower articular processes, which starts in a ring shape from the outermost edges to the central regions. Currently reported SFF occurred after posterior lumbar pedicle screw fixation. SFF may increase the stability of surgical segments and relieve clinical symptoms of patients. SFF is closely related to the method of lumbar internal fixation, facet osteoarthritis, interbody fusion, age, body mass index, type B fracture (according to AO classification), and the operative segment.

CONCLUSION

Most reported SFF occur after posterior lumbar pedicle screw fixation, which can increase lumbar stability, but the mechanism and influencing factors remain to be further clarified.

Anaesthetic management in a child with an atypical triad for reconstructive scoliosis surgery

Scoliosis may be of varied aetiology and may be associated with severe congenital anomalies. It often poses a challenge in its anaesthetic management. We present anaesthetic management of a child who underwent scoliosis reconstruction with a rare triad of cerebral palsy, glucose-6-phosphate dehydrogenase deficiency and severe mitral regurgitation. Anaesthetic management in these patients should focus primarily on associated co-morbidities and congenital anomalies affecting the course of the perioperative management and thereafter comprehensive pre-operative strategies must be executed to enhance the safety profile during the surgery.

Surgical treatment of scoliosis associated with central core disease: minimizing the effects of malignant hyperthermia with provocation tests

We report the case of a 7-year-old boy with thoracolumbar scoliosis and central core disease who had a history of malignant hyperthermia. He had scoliosis with Cobb's angle deteriorating to 67 degrees (thoracic) and 59 degrees (lumbar). A provocation test of general anesthesia was performed to confirm no hyperthermic reaction. Then, he underwent surgical correction by a posterior approach. The thoracic curve was reduced to 38 degrees and the lumbar curve to 42 degrees . He has been followed up for 2 years without any complications. This is the first report with a detailed description of perioperative management on surgical treatment of scoliosis associated with central core disease.