Congenital anteroposterior spinal dissociation in XXXX : report on two operated cases with long-term follow-up.

@entity1 @entity602 @entity33932 @entity85 @entity17589
STUDY DESIGN: The outcome of two @entity1 with @entity33932 after spinal surgery was evaluated after follow-up for 9 and 16 years. OBJECTIVE: To report on a new phenomenon of anteroposterior dissociation of the vertebrae in @entity33932 . To demonstrate that it can be visualized before surgery with imaging and also seen intraoperatively. To show that the neurologic recovery after surgery is sustained and to review the technical reasons for the difficulties in achieving a surgical fusion. The critical role of CT scanning will be illustrated. SUMMARY OF BACKGROUND DATA: The results of preoperative and postoperative radiologic investigations and intraoperative findings are presented to support this new phenomenon. METHODS: Two @entity1 underwent multiple spinal surgeries because of a deteriorating @entity17589 clinical status. Intraoperatively, anteroposterior dissociation was documented in both @entity1 . There was great difficulty in obtaining a surgical fusion, and an unusually long circumferential fusion was eventually necessary to obtain stability. Prolonged halo-vest immobilization was essential. RESULTS: Neurologic recovery was sustained over time, and the @entity85 did not deteriorate. CONCLUSION: Awareness of this phenomenon is essential to the management of @entity85 in @entity33932 when presenting with @entity602 . Special features in the radiologic workup should be sought after so as to plan staged surgical procedures. Conventional principles of planning of fusion levels are inadequate. Early treatment is advocated, as the neurologic compromise is reversible.
