Natural history of spinal deformity in a patient with Ehlers-Danlos syndrome: case report with 20-year follow-up

Spine J. 2011 Jul;11(7):e1-4. doi: 10.1016/j.spinee.2011.02.029. Epub 2011 Jun 2.

Abstract

Background context: Scoliosis can present in patients with Ehlers-Danlos syndrome (EDS) and can be surgically treated despite possible complications. The long-term natural history of the progression of spinal deformity, particularly scoliosis, and associated complications in EDS patients remains relatively unknown.

Purpose: To assess the progression of spinal deformity and associated complications in a patient with EDS, who was not surgically treated for her spine condition and was followed up for 20 years.

Study design: A case report.

Methods: A 9-year-old female with EDS presented to the orthopedic clinic with scoliosis and mild thoracic hyperkyphosis. The patient was followed up for a 20-year period. Progression of her spinal deformity and associated complications were noted.

Results: The patient's curve progressed rapidly in the initial follow-up period an 83° worsening from the age of 9 to 10 years. Because she refused surgical intervention, her spinal deformity continued to progress. As such, by the age of 29 years, she presented with 115° from T9 to L4 with severe hyperkyphosis. The patient eventually developed respiratory compromise and diminished functional capacity.

Conclusions: In patients with EDS, scoliosis may progress rapidly and unrelentingly, and if not treated early may lead to respiratory compromise. Close follow-up of such patients is imperative, and appropriate management should be sought to prevent potentially fatal morbidities.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Disease Progression*
  • Ehlers-Danlos Syndrome / complications
  • Ehlers-Danlos Syndrome / diagnostic imaging
  • Ehlers-Danlos Syndrome / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Kyphosis / diagnostic imaging
  • Kyphosis / etiology
  • Kyphosis / pathology*
  • Radiography
  • Scoliosis / diagnostic imaging
  • Scoliosis / etiology
  • Scoliosis / pathology*