Slow correction of severe spastic hyperlordosis in an adult by means of magnetically expandable rods

Christof Birkenmaier, Melvin D’Anastasi, Bernd Wegener, Carolin Melcher

We describe a case of severe and progressive lumbar hyperlordosis (160°) in a 28-year-old female university student with cerebral palsy. Her main complaints were abdominal wall pain and increasing inability to sit in her custom wheelchair. When deciding on our opinion about the most promising treatment strategy, we contemplated slow continued correction by means of percutaneously expandable magnetic rods (MAGEC) after the index surgery as a key component of a satisfactory correction in this severe and rigid curve. After an initial radical release and partial correction, a release and correction procedure was required for the bilateral hip flexion contracture. A final in situ posterior fusion was performed as a second spinal procedure, once the desired final correction at 66° of lumbar lordosis was achieved. Three years after the completion of surgery, the patient has a stable clinical and radiological result as well as a solid posterior fusion on CT. This is the first case published in which percutaneous magnetic distraction was successfully used in an adult patient.