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Published on: November 8, 2024
Treatment strategies and outcomes in the first reported case of severe "Reverse-Folding" spinal deformity: A 2-year
Jianming Zhang1, Chao Li1, Beiyu Xu1
1Peking University First Hospital, Beijing, China.
Introduction:
Severe spinal deformities represent rare and complex conditions requiring highly individualized treatment strategies. Among these, the "reverse-folding human" deformity has never before been reported in the medical literature. This study presents the first documented case of this condition, managed successfully through a multidisciplinary team approach and staged posterior spinal instrumentation and fusion. It also establishes the first framework for risk stratification and perioperative management of such extreme deformities.
Methods:
Case report.
Case Presentation:
A 36-year-old woman presented with progressive cervical hyperextension over 26 years and thoracolumbar deformity over 17 years. Clinical and radiological evaluation revealed severe cervical hyperextension, spinal lordosis (Cobb angle: 140.1°), scoliosis (Cobb angle: 87.6°), and severe restrictive pulmonary impairment. The patient underwent a two-stage posterior spinal fusion (C2-S1). Postoperative outcomes included substantial improvement in alignment and gait, with no neurological or mechanical complications over two years of follow-up.
Conclusion:
This case demonstrates the feasibility and efficacy of a staged full-spine surgical approach in managing unprecedented spinal deformities. The successful outcome highlights key elements for similar cases: patient-specific surgical planning, staged correction to reduce risks, and coordinated MDT involvement. This report provides a critical clinical reference and treatment framework for managing rare and severe spinal deformities, including the newly defined "reverse-folding human" condition.
