{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:53:17Z","timestamp":1792515197734,"version":"4.5.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:p>Surgical correction for kyphoscoliosis is increasingly being performed for patients with mucopolysaccharidosis (MPS). Reported case series have predominantly included patients with Type I (Hurler) and Type IV (Morquio) MPS. To their knowledge, the authors describe the first case report of surgical management of thoracolumbar kyphoscoliosis in Hunter syndrome (MPS Type II) and the rare occurrence of lumbar spondylolisthesis following surgical stabilization. A 12-year-old boy with Hunter syndrome presented with severe thoracolumbar kyphoscoliosis and no associated symptoms. Spinal radiographs demonstrated kyphosis of 48\u00b0 (T11-L3) and scoliosis of 22\u00b0 (T11-L3) with an anteriorly hypoplastic L-1 vertebra. The deformity progressed to kyphosis of 60\u00b0 and scoliosis of 42\u00b0 prior to surgical intervention. Spinal CT scans identified left T12-L1 facet subluxation, causing anterior rotatory displacement of the spine proximal to L-1 and bilateral L-5 isthmic spondylolysis with no spondylolisthesis. A combined single-stage anterior and posterior instrumented spinal arthrodesis from T-9 to L-4 was performed. Kyphosis and scoliosis were corrected to 4\u00b0 and 0\u00b0, respectively. Prolonged ventilator support and nasogastric feedings were required for 3 months postoperatively. At 2.5 years following surgery, the patient was asymptomatic, mobilizing independently, and had achieved a solid spinal fusion. However, he had also developed a Grade II spondylolisthesis at L4\u20135; this was managed nonoperatively in the absence of symptoms or further deterioration of the spondylolisthesis to the 3.5-year postoperative follow-up visit. Satisfactory correction of thoracolumbar kyphoscoliosis in Hunter syndrome can be achieved by combined anterior\/posterior instrumented arthrodesis. The risk of developing deformity or instability in motion segments adjacent to an instrumented fusion may be greater in patients with MPS related to the underlying connective tissue disorder.<\/jats:p>","DOI":"10.3171\/2015.6.spine15268","type":"journal-article","created":{"date-parts":[[2015,11,20]],"date-time":"2015-11-20T15:01:36Z","timestamp":1448031696000},"page":"402-406","source":"Crossref","is-referenced-by-count":12,"title":["Thoracolumbar kyphoscoliosis with unilateral subluxation of the spine and postoperative lumbar spondylolisthesis in Hunter syndrome"],"prefix":"10.3171","volume":"24","author":[{"given":"Simon B.","family":"Roberts","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios I.","family":"Tsirikos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine15268","series-title":"J Inherit Metab Dis","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10545-013-9630-2","article-title":"Surgical management of thoracolumbar kyphosis in mucopolysaccharidosis type 1 in a reference center","volume":"37","author":"Abelin Genevois","year":"2014"},{"key":"b2-spine15268","series-title":"J Bone Joint Surg Am","first-page":"1142","article-title":"Spondyloschisis following spine fusion","volume":"38-A","author":"Anderson","year":"1956"},{"key":"b3-spine15268","series-title":"Am J Pathol","first-page":"677","article-title":"Long-term effects of bone marrow transplantation in dogs with mucopolysaccharidosis I","volume":"134","author":"Breider","year":"1989"},{"issue":"Suppl 2","key":"b4-spine15268","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"S172","DOI":"10.1007\/s00586-012-2326-8","article-title":"AIS and spondylolisthesis","volume":"22","author":"Crostelli","year":"2013"},{"key":"b5-spine15268","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E539","DOI":"10.1097\/00007632-200112010-00020","article-title":"Anterior instrumented fusion for thoracolumbar kyphosis in mucopolysaccharidosis","volume":"26","author":"Dalvie","year":"2001"},{"key":"b6-spine15268","series-title":"Clin Orthop","first-page":"208","article-title":"Spondylolysis following spinal fusion. Report of a case","volume":"15","author":"Depalma","year":"1959"},{"issue":"190","key":"b7-spine15268","series-title":"Clin Orthop Relat Res","first-page":"132","article-title":"Acquired spondylolisthesis following scoliosis surgery. A case report","author":"Friedman","year":"1984"},{"key":"b8-spine15268","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.jpeds.2008.11.041","article-title":"Bone marrow transplantation in children with Hunter syndrome: outcome after 7 to 17 years","volume":"154","author":"Guffon","year":"2009"},{"key":"b9-spine15268","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1097\/00003086-197109000-00012","article-title":"Spondylolisthesis in children. Observations and surgical treatment","volume":"79","author":"Harrington","year":"1971"},{"key":"b10-spine15268","series-title":"Lancet","first-page":"735","article-title":"Bone marrow transplantation for inborn errors","volume":"2","author":"Hobbs","year":"1981"},{"key":"b11-spine15268","series-title":"Orthop Rev (Pavia)","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.4081\/or.2010.e16","article-title":"Orthopedic manifestations in patients with mucopolysaccharidosis type II (Hunter syndrome) enrolled in the Hunter Outcome Survey","volume":"2","author":"Link","year":"2010"},{"key":"b12-spine15268","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.2106\/00004623-196547060-00014","article-title":"Spondylolysis: a complication of spine fusion","volume":"47","author":"Rombold","year":"1965"},{"key":"b13-spine15268","series-title":"J Bone Joint Surg Br","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1302\/0301-620X.78B6.0780938","article-title":"Spinal problems in mucopolysaccharidosis I (Hurler syndrome)","volume":"78","author":"Tandon","year":"1996"},{"issue":"117","key":"b14-spine15268","series-title":"Clin Orthop Relat Res","first-page":"176","article-title":"Spondylolisthesis following surgical fusion for scoliosis: a case report","author":"Tietjen","year":"1976"},{"key":"b15-spine15268","series-title":"J Bone Joint Surg Br","first-page":"751","article-title":"Spondylolysis and spondylolisthesis in children and adolescents","volume":"92","author":"Tsirikos","year":"2010"},{"key":"b16-spine15268","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1097\/BRS.0000000000000157","article-title":"Thoracolumbar kyphosis in treated mucopolysaccharidosis 1 (Hurler syndrome)","volume":"39","author":"Yasin","year":"2014"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/24\/3\/article-p402.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/24\/3\/article-p402.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/24\/3\/article-p402.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:51:26Z","timestamp":1681595486000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/24\/3\/article-p402.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3]]},"references-count":16,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2015.6.spine15268","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2016,3]]}}}