Surgical Correction of Fixed Kyphosis

Cho, Woo-Jin; Kang, Chang-Nam; Park, Ye‐Soo; Kim, Hyoung-Jin; Cho, Jae-Lim

doi:10.4184/asj.2007.1.1.12

Cited by 23 publications

(14 citation statements)

References 16 publications

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“…A retrospective study carried out by Cho et al 12 to 23 patients with rigid fixed kyphosis resulted in 57% rate of correction. Although the study combined all approaches (anterior, posterior, and combined posterior and anterior), the result was comparable to our case, where the rate of correction was 56%.…”

Section: Discussionmentioning

confidence: 99%

Correction in a severe post-tuberculosis kyphosis using modified posterior vertebral column resection

Ivansyah

Saleh

2018

JOTI

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Introduction: Kyphotic Deformity is one of the complications that affect the quality of life in patients post-tuberculosis. Patients with significant kyphosis typically present cosmetic and functional problems related to the biomechanical changes. There are many types of kyphotic deformity corrections, the posterior approach allows bigger degree of correction, but its main problem is neurological deficit during or post-surgery. Therefore, we correct the deformity by performing gradual cantilever bending after vertebral resection. Methods: We present a case: a 31 year-old female diagnosed with severe kyphosis in healed spondylitis tuberculosis. The patient was diagnosed with lung and spine tuberculosis 20 years ago and she was treated with anti-TB drugs for 12 months. Physical examination showed severe kyphotic deformity of 91 degrees. Although the patient did not have any neurological deficit or pain, the patient had difficulty when lying on bed and she also complained about getting easily fatigue, hence she agreed on the correction procedure. The procedure took place at Cipto Mangunkusumo Hospital dated January 24 th 2017. The Surgery was performed by an attending spine surgeon, one spine fellow surgeon and two orthopedic residents. The technique used was a modification of posterior approach of vertebral column resection with gradual bending. The length of surgery was 7 hours, with 2100 ml blood loss during the surgery. Results: Pre-and post-operative X-rays was compared with Cobb method, pre-operative X-ray was 91.47 o compared to post-operative X-ray which was 51.35 o. There was no major event observed. The patient was discharged 7 days postoperative without any neurological deficit. Kesimpulan: Prosedur pendekatan posterior satu tahap yang dimodifikasi adalah metode yang aman dan efektid untuk koreksi kifosis berat pasca tuberculosis.

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Section: Discussionmentioning

confidence: 99%

Correction in a severe post-tuberculosis kyphosis using modified posterior vertebral column resection

Ivansyah

Saleh

2018

JOTI

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“…Several recent articles have demonstrated that PVCR may lead to major complications, especially neurological injuries. 3 , 31 , 32 For example, Wang et al 31 evaluated the efficacy and safety of PVCR for 24 patients with congenital SAK. These patients had an average segmental kyphosis 87.3° preoperatively.…”

Section: Discussionmentioning

confidence: 99%

“… 1 On the other hand, when the sagittal Konstam's angle was more than 90°, the patients had difficulty in movement later, they may acquire cardiopulmonary problems or can experience low back or costopelvic impingement pain, which can deteriorate the function of respiration and digestion due to compressive effects of the deformity on the abdomen and may cause neurological deficit that cause morbidity. 2 , 3 There is a need for complex and complicated surgery for their treatment such as vertebral column resection (VCR). VCR includes resection of one or more vertebral segments and can be implemented using either only posterior procedure or combined anterior and posterior procedures.…”

Section: Introductionmentioning

confidence: 99%

Analysis of complications following posterior vertebral column resection for the treatment of severe angular kyphosis greater than 100°

Atıcı

Balioğlu²,

Kargın³

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°.MethodsThe medical records of 17 patients (mean age 17.9 (range, 9–27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24–64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients. The sagittal plane parameters (local kyphosis angle, lumbar lordosis, sagittal vertical axis, pelvic tilt, sacral slope and pelvic incidence) were measured in the preoperative and the early postoperative periods and during the last follow-up on the lateral radiographs.ResultsThe mean preoperative localized kyphosis angle was 121.8° (range, 101°–149°). The mean local kyphosis angle (LKA) was 71.5° at postoperatively evaluation (p < 0.05). Complications were detected in 12 patients (70.6%) with spinal shock in 4 patients, hemothorax in 3 patients, postoperative infection in 2 patients, dural laceration in 2 patients, neurological deficit in 2 patients (1 paraplegia and 1 root injury), the shifted cage in 2 patients and rod fracture in 2 patients. Neurological events occurred in six patients (35%) with temporary neurological deficit in 5 patients and permanent neurological deficit in 1 patient.ConclusionPVCR is an efficient and a successful technique for the correction of SAK. However, it can lead to a large number of major complications in SAK greater than 100°.Level of evidenceLevel IV, therapeutic study.

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“…The number of patients in most previous studies ranged between 9 and 24. 1,3,[6][7][8][9] No rule exists for conservative treatment with cast or braces. 3,5,10,11 Surgical treatment is the best choice for these cases considering the patients' age range, types, sizes of the deformity, and their neurological statuses.…”

Section: Introductionmentioning

confidence: 99%

Severe thoracolumbar congenital kyphosis treated with single posterior approach and gradual “in situ” correction

Audat

Radaideh

Odat

et al. 2020

J Orthop Surg (Hong Kong)

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Background: Congenital kyphosis results from the failed formation of the vertebrae during the embryonic period and may be associated with cardiac, urogenital, or spinal cord anomalies. Surgical treatment is the best choice through anterior, posterior, or both approaches. Objectives: This study aims to evaluate the effect of posterior gradual correction using the “in situ” bender to correct severe thoracolumbar congenital kyphosis with or without osteotomy or excision of the vertebra. Methods: Twenty-five patients with an age range of 2–23 (mean ± SD = 12.58 ± 6.03) years with severe thoracolumbar kyphosis were treated surgically at our institution between 2004 and 2013. Pedicle screwing, osteotomy, and gradual “in situ” bending through the single posterior approach were the choices of treatment. Cobb’s angle, patient’s height, and SRS-22r were used to evaluate the patients preoperatively and postoperatively. Follow-up periods were 35–136 months. Result: Cobb’s angle pre-surgery range was 35–180 (81.48 ± 39.1) degrees improved post-surgery to 0–45 (21.72 ± 13.47) degrees ( p-value <0.0001). The range of patients’ standing height pre-surgery was 79–170 (142.42 ± 24.85) centimeters increased after surgery to 81–175 (147.76 ± 26.33) centimeters ( p-value <0.0001). SRS-22r pre-surgery range was between 2.12 and 3.904 (3.2 ± 0.77) and improved post-surgery to 4.16 and 4.96 (4.59 ± 0.29) ( p-value = 0.046). Conclusion: Gradual correction with the “in situ” bender with or without osteotomy through the single posterior approach can give satisfying clinical (patients’ standing height and SRS-22r scores) and radiological (Cobb’s angle) results to treat severe congenital thoracolumbar kyphosis.

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Surgical Correction of Fixed Kyphosis

Cited by 23 publications

References 16 publications

Correction in a severe post-tuberculosis kyphosis using modified posterior vertebral column resection

Correction in a severe post-tuberculosis kyphosis using modified posterior vertebral column resection

Analysis of complications following posterior vertebral column resection for the treatment of severe angular kyphosis greater than 100°

Severe thoracolumbar congenital kyphosis treated with single posterior approach and gradual “in situ” correction

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