Cervical kyphoscoliosis due to substance abuse: a case series on introduction and neurosurgical treatment

Majid Rezvani; Mohammadreza Mehrabanian; Omid R Hariri; Colin Son; Noushin Vahdat; Mina Foroughi; Ariel Takayanagi; Sara Mirza; Sadegh Baradaran Mahdavi; Arman Sourani

doi:10.1007/s43390-024-00989-7

Cervical kyphoscoliosis due to substance abuse: a case series on introduction and neurosurgical treatment

Spine Deform. 2024 Oct 22. doi: 10.1007/s43390-024-00989-7. Online ahead of print.

Authors

Majid Rezvani¹, Mohammadreza Mehrabanian², Omid R Hariri³, Colin Son^{4

5}, Noushin Vahdat^{6

7}, Mina Foroughi⁸, Ariel Takayanagi^{9

10}, Sara Mirza^{6

11}, Sadegh Baradaran Mahdavi^{12

13}, Arman Sourani^{14

15}

Affiliations

¹ Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Neurosurgery, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
³ Department of Neurological Surgery, Kaiser Permanente Orange County, Anaheim, CA, USA.
⁴ Neurosurgical Associates of San Antonio, San Antonio, TX, USA.
⁵ School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX, USA.
⁶ Department of Radiology, University of San Diego California, San Diego, CA, USA.
⁷ Department of Radiology Veteran Administration Healthcare System, San Diego, CA, USA.
⁸ Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
⁹ Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
¹⁰ Department of Neurological Surgery, Riverside University Health System, Moreno Valley, CA, USA.
¹¹ Department of Science and Engineering, Tulane University, New Orleans, LA, USA.
¹² Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
¹³ Student Research Committee, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
¹⁴ Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. [email protected].
¹⁵ Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Sandy, UT, USA. [email protected].

PMID: 39438430
DOI: 10.1007/s43390-024-00989-7

Abstract

Study design: A prospective case series.

Objective: To investigate the possible associations of multi-directional cervical kyphoscoliosis (CKS) with substance abuse and evaluate treatment outcomes. CKS is a rare medical situation without a well-established pathology. Still there are many obscurities in treatment paradigms and outcomes. To our knowledge, there is no published report on the association between CKS with addiction. Besides the novel report of such a rare etiology for CSK, the complexity of the neurosurgical treatment makes this report the first of its kind.

Methods: In this series, we presented three patients with a history of crack cocaine addiction who suffered CKS due to prolonged hand-over-neck posture and treated all of them with a complex neurosurgical protocol.

Results: All cases were operated on and restored their normal spine alignment. Their long-term outcomes showed independent neurological status with no major surgical complications.

Conclusion: Crack cocaine addiction might be associated with CKS in long-term cocaine abuse. A complex neurosurgical approach can achieve a sustainable clinical outcome.

Keywords: Anterior cervical discectomy and fusion; Cervical kyphoscoliosis; Cervical kyphosis; Coronal imbalance; Posterior cervical fusion; Rotational neck deformity; Sagittal imbalance.