This patient had Spina Bifida and severe scoliosis.
Patients with Spina Bifida have a various degrees of missing posterior spinal elements exposing the neural elements. The missing bony elements of the back of the spine also do not allow for a normal fusion bed for a posterior fusion. Therefore, we have to rely on anterior disc space to get a reliable fusion.
He underwent an anterior release with discectomies to release the spine and make it more flexible. A vertebrectomy or removal of a vertebral body was also performed to shorten the spine and aid in correction of the severe scoliosis and level the pelvis.
The vertebrectomy was completed posteriorly followed by correction of the deformity with instrumentation.
The vertebrectomy really helps in getting correction of the pelvic obliquity as shown in the comparison radiographs of before and after the surgery.
The correction of the lumbar lordosis and sagittal plane or the swayback is also apparent on the x-rays.