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The patient underwent a two-stage operation. MRI showed anterior disc height loss and fusion at these levels (Fig. Radiographs revealed anterior narrowing at the T8/L1 and L2/3disc spaces with a kyphosis measuring 85° (Fig. Her neurological status and lab tests were normal. Other symptoms were not observed and there was no family history of spinal deformity. 2c).Ī Iranian female at age 19 was presented with a history of progressive, painless thoracolumbar kyphosis after the age of 10. The deformity correction was obtained with a T1–T12 kyphosis measuring 43° at the 5-year postoperative follow-up (Fig. Then, spinal surgery was performed with multilevel ponte osteotomy, T2 hook, and T3–L2 pedicular screw insertion and fusion. A positive bone scan was observed at this age. Also, the T8–T12 kyphosis changed from 38 to 43°. During brace treatment, the reduction of T1–T12 kyphosis from 70 to 63° was observed due to the effect of the brace on the upper and middle thoracic segments, which was not significant. Subsequent radiographs and MRI showed progressive disc space narrowing and end-plate erosions anteriorly at the T8–T12 levels, and eventual anterior bony fusion by the age of 16 with a thoracic kyphosis measuring 63° (Fig.

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On spinal brace treatment and serial clinical evaluation, the deformity persisted from the ages of 12 to 16. Due to parents’ opposition, surgery was not performed and conservative treatment was considered. Initial examination didn’t show any back pain and neurological deficit. Bone scan imaging could be considered as an aid to differential diagnosis, which is an effective method.Ī Iranian male patient presented at age 12 with a T1–T12 kyphosis measuring 70°.

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The treatment of CS with PSO plus ponte osteotomy seems to result in an excellent surgical procedure and outcome for our patients based on deformity severity. In postoperative follow-up, the deformity correction was achieved with proper alignment in all the cases. Finally, all patients were treated according to their clinical conditions through a combined surgical approach such as pedicle subtraction osteotomy (PSO), ponte osteotomy, hook, pedicular screw insertion, and fusion. Case 2 received conservative treatment braces and regular follow-up. Patients underwent clinical and radiological examination (MRI, CT scan, and bone scan) before surgery and revealed Copenhagen syndrome. The mean age of patients were 14.0 (SD = 3.6) years at admission time.

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We report a series of three patients of CS with good outcome. The onset of the disease, with a progressive anterior vertebral ankylosis in the thoracic and/or lumbar areas often clinically revealed by thoracolumbar kyphosis. Copenhagen syndrome (CS) is a rare disorder mostly observed in adolescent.

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