Surgical correction of Hip-spine syndrome in a child with mucopolysaccharidosis type IVb: 10 years follow-up

Relevance. According to the results of surgical treatment, the sagittal imbalance of the spine was eliminated, the pain syndrome was stopped, and the patient’s independent movement was restored without the use of auxiliary devices (walkers).

Results. In patients with combined pathology of the spine and hip joints, violations of the X-ray anatomical indices of the trunk balance lead to the development of severe pain syndrome, reduces exercise tolerance, and the quality of life. Correction of sagittal imbalance of the trunk becomes particularly relevant in this group of patients.

Conclusion. If it is impossible to perform hip replacement to correct sagittal imbalance of the trunk in patients with combined pathology of the hip joint and spine corrective osteotomy of the lumbar spine is a non-standard treatment method, is potent of improving prognosis and quality of life in patients.

Contribution:
Chelpachenko O.B. — concept and design of the study, statistical processing of the material, editing the text;
Chelpachenko O.B., Butenko A.S., Pimbursky I.P. — collection and processing of the material;
Plotnikov A.P. — writing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 22, 2024
Accepted: December 06, 2024
Published: December 25, 2024

1. Roaf R. The basic anatomy of scoliosis. J. Bone Joint. Surg. Br. 1966; 48(4): 786–92.

2. de Jonge T., Dubousset J.F., Illés T. Sagittal plane correction in idiopathic scoliosis. Spine (Phila Pa 1976). 2002; 27(7): 754–60. https://doi.org/10.1097/00007632-200204010-00013

3. Chernyad’eva M.A., Vasyura A.S. Surgical treatment of progressive idiopathic scoliosis in adolescents aged 10–14 years: literature review. Khirurgiya pozvonochnika. 2019; 16(3): 33–40. https://doi.org/10.14531/ss2019.3.33-40 (in Russian)

4. Solla F., Ilharreborde B., Clément J.L., Rose E.O., Monticone M., Bertoncelli C.M., et al. Patient-specific surgical correction of adolescent idiopathic scoliosis: a systematic review. Children (Basel). 2024; 11(1): 106. https://doi.org/10.3390/children11010106

5. Offierski C.M., MacNab I. Hip-spine syndrome. Spine (Phila Pa 1976). 1983; 8(3): 316–21. https://doi.org/10.1097/00007632-198304000-00014

6. Borgo A., Cossio A., Gallone D., Vittoria F., Carbone M. Orthopaedic challenges for mucopolysaccharidoses. Ital. J. Pediatr. 2018; 44(Suppl. 2): 123. https://doi.org/10.1186/s13052-018-0557-y

7. Padash S., Obaid H., Henderson R.D.E., Padash Y., Adams S.J., Miller S.F., et al. A pictorial review of the radiographic skeletal findings in Morquio syndrome (mucopolysaccharidosis type IV). Pediatr. Radiol. 2023; 53(5): 971–83. https://doi.org/10.1007/s00247-022-05585-3

8. Sergeenko O.M., Evsyukov A.V., Filatov E.Y., Ryabykh S.O., Burtsev A.V., Gubin A.V. Cervicothoracic dislocation due to congenital and bone-dysplasia-related vertebral malformations. Spine Deform. 2023; 11(5): 1223–38. https://doi.org/10.1007/s43390-023-00690-1

9. Feng B., Qiu G., Shen J., Zhang J., Tian Y., Li S., et al. Impact of multimodal intraoperative monitoring during surgery for spine deformity and potential risk factors for neurological monitoring changes. J. Spinal. Disord. Tech. 2012; 25(4): 108–14. https://doi.org/10.1097/bsd.0b013e31824d2a2f

10. Bessette B.J., Fassier F., Tanzer M., Brooks C.E. Total hip arthroplasty in patients younger than 21 years: a minimum, 10-year follow-up. Can. J. Surg. 2003; 46(4): 257–62.

11. Finkbone P.R., Severson E.P., Cabanela M.E., Trousdale R.T. Ceramic-on-ceramic total hip arthroplasty in patients younger than 20 years. J. Arthroplasty. 2012; 27(2): 213–9. https://doi.org/10.1016/j.arth.2011.05.022

12. Kamath A.F., Sheth N.P., Hosalkar H.H., Babatunde O.M., Lee G.C., Nelson C.L. Modern total hip arthroplasty in patients younger than 21 years. J. Arthroplasty. 2012; 27(3): 402–8. https://doi.org/10.1016/j.arth.2011.04.042

13. Yamada K., Sudo H., Abe Y., Kokabu T., Tachi H., Endo T., et al. Influence of lateral translation of lowest instrumented vertebra on L4 tilt and coronal balance for thoracolumbar and lumbar curves in adolescent idiopathic scoliosis. J. Clin. Med. 2023; 12(4): 1389. https://doi.org/10.3390/jcm12041389

14. Gupta M.C., Gupta S., Kelly M.P., Bridwell K.H. Pedicle subtraction osteotomy. JBJS Essent. Surg. Tech. 2020; 10(1): e0028.1–11. https://doi.org/10.2106/JBJS.ST.19.00028

15. Wang M.Y. Miniopen pedicle subtraction osteotomy: surgical technique and initial results. Neurosurg. Clin. N. Am. 2014; 25(2): 347–51. https://doi.org/10.1016/j.nec.2013.12.012

16. Hyun S.J., Kim Y.J., Rhim S.C. Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients. World J. Clin. Cases. 2013; 1(8): 242–8. https://doi.org/10.12998/wjcc.v1.i8.242

17. Hamilton D.K., Smith J.S., Sansur C.A., Glassman S.D., Ames C.P., Berven S.H., et al. Rates of new neurological deficit associated with spine surgery based on 108,419 procedures: A report of the scoliosis research society morbidity and mortality committee. Spine (Phila Pa 1976). 2011; 36(15): 1218–28. https://doi.org/10.1097/brs.0b013e3181ec5fd9