Surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach
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Surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach. / Spiro, A S; Rupprecht, Martin; Stenger, P; Hoffmann, Michael; Kunkel, P; Kolb, J P; Rueger, J M; Stücker, Ralf.
In: BONE JOINT J, Vol. 95-B, No. 11, 01.11.2013, p. 1527-32.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach
AU - Spiro, A S
AU - Rupprecht, Martin
AU - Stenger, P
AU - Hoffmann, Michael
AU - Kunkel, P
AU - Kolb, J P
AU - Rueger, J M
AU - Stücker, Ralf
PY - 2013/11/1
Y1 - 2013/11/1
N2 - A combined anterior and posterior surgical approach is generally recommended in the treatment of severe congenital kyphosis, despite the fact that the anterior vascular supply of the spine and viscera are at risk during exposure. The aim of this study was to determine whether the surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach is feasible, safe and effective. We reviewed the records of ten patients with a mean age of 11.1 years (5.4 to 14.1) who underwent surgery either by pedicle subtraction osteotomy or by vertebral column resection with instrumented fusion through a single posterior approach. The mean kyphotic deformity improved from 59.9° (45° to 110°) pre-operatively to 17.5° (3° to 40°) at a mean follow-up of 47.0 months (29 to 85). Spinal cord monitoring was used in all patients and there were no complications during surgery. These promising results indicate the possible advantages of the described technique over the established procedures. We believe that surgery should be performed in case of documented progression and before structural secondary curves develop. Our current strategy after documented progression is to recommend surgery at the age of five years and when 90% of the diameter of the spinal canal has already developed.
AB - A combined anterior and posterior surgical approach is generally recommended in the treatment of severe congenital kyphosis, despite the fact that the anterior vascular supply of the spine and viscera are at risk during exposure. The aim of this study was to determine whether the surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach is feasible, safe and effective. We reviewed the records of ten patients with a mean age of 11.1 years (5.4 to 14.1) who underwent surgery either by pedicle subtraction osteotomy or by vertebral column resection with instrumented fusion through a single posterior approach. The mean kyphotic deformity improved from 59.9° (45° to 110°) pre-operatively to 17.5° (3° to 40°) at a mean follow-up of 47.0 months (29 to 85). Spinal cord monitoring was used in all patients and there were no complications during surgery. These promising results indicate the possible advantages of the described technique over the established procedures. We believe that surgery should be performed in case of documented progression and before structural secondary curves develop. Our current strategy after documented progression is to recommend surgery at the age of five years and when 90% of the diameter of the spinal canal has already developed.
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Female
KW - Follow-Up Studies
KW - Germany
KW - Humans
KW - Kyphosis
KW - Lumbar Vertebrae
KW - Male
KW - Osteotomy
KW - Postoperative Complications
KW - Thoracic Vertebrae
KW - Treatment Outcome
U2 - 10.1302/0301-620X.95B11.31376
DO - 10.1302/0301-620X.95B11.31376
M3 - SCORING: Journal article
C2 - 24151274
VL - 95-B
SP - 1527
EP - 1532
JO - BONE JOINT J
JF - BONE JOINT J
SN - 2049-4394
IS - 11
ER -
