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Introduction <p>Severe spinal deformities represent rare and complex conditions requiring highly individualized treatment strategies. Among these, the “reverse-folding human” deformity has never before been reported in the medical literature. This study presents the first documented case of this condition, managed successfully through a multidisciplinary team approach and staged posterior spinal instrumentation and fusion. It also establishes the first framework for risk stratification and perioperative management of such extreme deformities.</p> Methods <p>Case report.</p> Case presentation <p>A 36-year-old woman presented with progressive cervical hyperextension over 26 years and thoracolumbar deformity over 17 years. Clinical and radiological evaluation revealed severe cervical hyperextension, spinal lordosis (Cobb angle: 140.1°), scoliosis (Cobb angle: 87.6°), and severe restrictive pulmonary impairment. The patient underwent a two-stage posterior spinal fusion (C2–S1). Postoperative outcomes included substantial improvement in alignment and gait, with no neurological or mechanical complications over two years of follow-up.</p> Conclusion <p>This case demonstrates the feasibility and efficacy of a staged full-spine surgical approach in managing unprecedented spinal deformities. The successful outcome highlights key elements for similar cases: patient-specific surgical planning, staged correction to reduce risks, and coordinated MDT involvement. This report provides a critical clinical reference and treatment framework for managing rare and severe spinal deformities, including the newly defined “reverse-folding human” condition.</p>

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Treatment strategies and outcomes in the first reported case of severe “Reverse-Folding” spinal deformity: A 2-year follow-up case report

  • 期刊论文

  • 发表日期：

    2025年12月22日

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  • Jianming Zhang,
  • Chao Li,
  • Beiyu Xu,
  • Yao Zhao,
  • Longtao Qi,
  • Lei Yue,
  • Chunde Li,
  • Yu Wang

摘要

Introduction

Severe spinal deformities represent rare and complex conditions requiring highly individualized treatment strategies. Among these, the “reverse-folding human” deformity has never before been reported in the medical literature. This study presents the first documented case of this condition, managed successfully through a multidisciplinary team approach and staged posterior spinal instrumentation and fusion. It also establishes the first framework for risk stratification and perioperative management of such extreme deformities.

Methods

Case report.

Case presentation

A 36-year-old woman presented with progressive cervical hyperextension over 26 years and thoracolumbar deformity over 17 years. Clinical and radiological evaluation revealed severe cervical hyperextension, spinal lordosis (Cobb angle: 140.1°), scoliosis (Cobb angle: 87.6°), and severe restrictive pulmonary impairment. The patient underwent a two-stage posterior spinal fusion (C2–S1). Postoperative outcomes included substantial improvement in alignment and gait, with no neurological or mechanical complications over two years of follow-up.

Conclusion

This case demonstrates the feasibility and efficacy of a staged full-spine surgical approach in managing unprecedented spinal deformities. The successful outcome highlights key elements for similar cases: patient-specific surgical planning, staged correction to reduce risks, and coordinated MDT involvement. This report provides a critical clinical reference and treatment framework for managing rare and severe spinal deformities, including the newly defined “reverse-folding human” condition.