Retrospective analysis of complications after surgical treatment of congenital kyphosis in children

Andrey Mezentsev, Dmytro Demchenko, Dmytro Petrenko


Congenital kyphosis occurs as a result of a disruption in the formation or vertebral segmentation in the presence of active semi-vertebra, characterized by rapid progression and, as a rule, development of significant neurological complications. The main surgeries at congenital kyphosis are: ventral and/or posterior fusion in situ, with or without metal devices, vertebroectomy and osteotomy in different modifications. Among postoperative complications in patients with congenital kyphosis, the most common are neurological and fractures of metal devices.

Objective: to conduct a retrospective analysis of surgical outcomes of the treatment of congenital kyphosis in children.

Methods: case histories were analyzed, patients with congenital kyphosis, whose age did not exceed 18 years, and the follow-up period was at least 2 years after the operation. We assessed the value of the total and local kyphosis, lumbar lordosis. Infectious complications, deformity progression, as well as the complications associated with the instability of metal devices were analyzed.

Results: of the 25 patients, 5 had complications: metal device instability with the loss of correction in 3 cases, the infectious — 1, the increase in total kyphosis — 1. In 4 patients revision surgeries were made.

Conclusions: use of existing technologies for surgical treatment of congenital kyphosis leads to development of complications after operations. Their main reasons were tactical errors associated with inadequate evaluation of growth potential of the spine, as well as instability of metal devices due to lack of mature bone block. It is necessary to create a technology that can model the growth of the spine and contribute the bone block in the place of osteotomy.


congenital kyphosis; surgical treatment; complications; decancellation; vertebroectomy


Dickson, R. A., Stamper, P., Sharp, A. M., & Harker, P. (1980). School screening for scoliosis: cohort study of clinical course. BMJ, 281(6235), 265–267. doi:10.1136/bmj.281.6235.265

McMaster, M. J., & Singh, H. (2001). The surgical management of congenital kyphosis and kyphoscoliosis. Spine, 26(19), 2146–2154. doi:10.1097/00007632-200110010-00021

Zhao, H., Weng, X., Qiu, G. [et al.] (1999) The surgical treatment of congenital kyphosis. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 21(2), 146–150.

Winter, R. B., Moe, J. H., & Lonstein, J. E. (1985). The surgical treatment of congenital kyphosis. Spine, 10(3), 224–231. doi:10.1097/00007632-198504000-00006

Song, Y., Liu, L., Kong, Q., Zeng, J., Wang, L., Pei, F., … Li, T. (2011). Comparison of one-stage anteroposterior and posterior-alone hemivertebrae resection combined with posterior correction for hemivertebrae deformity: Results of 60 patients. Indian Journal of Orthopaedics, 45(6), 492. doi:10.4103/0019-5413.87115

Wang, Y., & Lenke, L. G. (2011). Vertebral column decancellation for the management of sharp angular spinal deformity. European Spine Journal, 20(10), 1703–1710. doi:10.1007/s00586-011-1771-0

Zeng, Y., Chen, Z., Qi, Q., Guo, Z., Li, W., Sun, C., & Liu, N. (2012). The posterior surgical correction of congenital kyphosis and kyphoscoliosis: 23 cases with minimum 2 years follow-up. European Spine Journal, 22(2), 372–378. doi:10.1007/s00586-012-2463-0

Zeng, Y., Chen, Z., Guo, Z., Qi, Q., Li, W., & Sun, C. (2013). Complications of correction for focal kyphosis after posterior osteotomy and the corresponding management. Journal of Spinal Disorders and Techniques, 26(7), 367–374. doi:10.1097/bsd.0b013e3182499237

Lenke, L. G., Newton, P. O., Sucato, D. J., Shufflebarger, H. L., Emans, J. B., Sponseller, P. D., … Blanke, K. M. (2013). Complications After 147 Consecutive vertebral column resections for severe pediatric spinal deformity. Spine, 38(2), 119–132. doi:10.1097/brs.0b013e318269fab1

Papadopoulos, E. C, Boachie-Adjei, O., Hess, W. F., Sanchez Perez-Grueso, F. J., Pellisé, F., Gupta, M., Lonner, B., Paonessa, K., Faloon, M., Cunningham, M. E., Kim, H. J., Mendelow, M., Sacramento, C., Yazici, M. (2013) Early outcomes and complications of posterior vertebral column resection. Spine Journal, 5(5), 983–991. doi: 10.1016/j.spinee.2013.03.023

Kim, Y. J., Otsuka, N. Y., Flynn, J. M. [et al.] (2001) Surgical treatment of congenital kyphosis. Spine, 26(20), 2251–2257.

Viviani, G. R., Raducan, V., Bednar, D. A., Grandwilewski, W. (1993) Anterior and posterior spinal fusion: comparison of one-stage and two-stage procedures. Canadian Journal of Surgery, 36(5), 468–473.

Mezentsev, A. A., Kudimov, S., A., Petrenko, D. E. (2005) Complication of surgical treatment on anterior vertebral column. Orthopaedics, Traumatology and Prosthetics, 1, 37–40. (in Ukraine)

Mezentsev, A. A., Petrenko, D. E., Barkov, A. A. (2007) Result of scoliosis surgical treatment using SRS-30. Orthopaedics, Traumatology and Prosthetics, 4, 17–21. (in Ukraine)

Radchenko, V. A., Mezentsev, A. A., Korolkov, A. I., Petrenko, D. E. (2006) Variation of spinal-pelvic balance in orthopedic patients Chronicle of traumatology and orthopedics, 1–2, 60–63.

Radchenko, V. A., Korzh, N. A. (2004) Mannual of tabilization of thoracic and lumbar spine. Kharkiv: Prapor. (in Ukraine)

Copyright (c) 2018 Andrey Mezentsev, Dmytro Demchenko, Dmytro Petrenko

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.