Surgical treatment of congenital kyphosis (literature review)
Congenital kyphosis is caused by vertebral formation or segmentation failures and the presence of active hemivertebrae, characterized by rapid progression and, as a rule, the development of major neurological complications. Various surgical techniques congenital kyphosis are known. In our opinion, a further improvement in the results of treatment of this disease is impossible without analysis.
Objective: based on analysis of the scientific literature on outcomes and complications of treatment of congenital kyphosis, identify the advantages and disadvantages of the existing methods of surgical treatment of this pathology.
Methods: published in international scientific journals, scientific papers on treatment of congenital kyphosis. Search performed on servers Medline and PubMed.
Results: of 795 articles identified 20 works selected, in which the following surgical methods are described: pedicle subtraction osteotomy, spinal decancellation, posterior vertebrectomy, anteroposterior vertebrectomy, in situ fusion. The largest correction was achieved in patients who underwent spinal vertebrectomy and decancellation or pedicle subtraction osteotomy. However, in these patients recorded the highest level of intra- and postoperative complications.Conclusions: currently, in the surgical treatment of congenital kyphosis, preference is given to vertebrectomy, decancellation and pedicular subtraction osteotomy. The main intra- and postoperative complications are: hemorrhage, spinal cord injury, neurological deficit, pseudarthrosis, loss of correction achieved. A promising area of surgery of congenital kyphosis is to develop technology that would achieve sufficient correction of the curvature in conjunction with minimizing complications and preserving spinal growth.
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