Surgical treatment of congenital kyphosis (literature review)

Dmytro Demchenko, Andrey Mezentsev, Dmytro Petrenko

Abstract


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.

Keywords


congenital kyphosis; surgical treatment; vertebrectomy; spinal osteotomy

References


van Loon PJ, van Stralen G, van Loon CJ, van Susante JL. A pedicle subtraction osteotomy as an adjunctive tool in the surgical treatment of a rigid thoracolumbar hyperkyphosis; a preliminary report. Spine J. 2006;6(2):195–200.

Wang L, Song Y, Pei F, Liu L, Liu H, Kong Q, Li T, Zeng J. Comparison of one-stage anteroposterior and posterior-alone hemivertebrae resection combined with posterior correction for hemivertebrae deformity. Indian J Orthop. 2011;45(6):492–9. doi: 10.4103/0019-5413.87115.

Lenke LG, Newton PO, Sucato DJ, Shufflebarger HL, Emans JB, Sponseller PD, Shah SA, Sides BA, Blanke KM. Complications after 147 consecutive vertebral column resections for severe pediatric spinal deformity: a multi¬center analysis. Spine.2013;38(2):119–32. doi: 10.1097/BRS.0b013e318269fab1.

Zeng Y, Chen Z, Guo Z, Qi Q, Li W, Sun C. Complications of correction for focal kyphosis after posterior osteotomy and the corresponding management. J Spine Disord. Tech. 2013;26(7):367–74. doi: 10.1097/BSD.0b013e3182499237.

Dickson RA, Stamper P, Sharp AM, Harker P. School screening for scoliosis: cohort study of clinical course. Br. Med. J 1980;281:265–7.

Saraph VJ, Bach CM, Krismer M, Wimmer C. Evaluation of spinal fusion using autologous anterior strut grafts and posterior instrumentation for thoracic/thoracolumbar kyphosis. Spine. 2005;30(14):1594–601.

Kim YJ, Otsuka NY, Flynn JM. Surgical treatment of congenital kyphosis. Spine. 2001;26(20):2251–57.

McMaster MJ, Singh H. The surgical management of congenital kyphosis and kyphoscoliosis. Spine. 2001;26(19):2146–54.

Qi Q, Chen ZQ, Guo ZQ, Le WS. New type spinal osteotomy with cage inserting anteriorly and closing posteriorly to correct thoracolumbar kyphosis by a single posterior approach. Zhonghua Wai Ke Za Zhi. 2006(8):551–5.

Papadopoulos EC, Boachie-Adjei O, Hess WF, Sanchez Perez-Grueso FJ, Pellisé F, Gupta M, Lonner B, Paonessa K, Faloon M, Cunningham ME, Kim HJ, Mendelow M, Sacramento C, Yazici M; Foundation of Orthopedics and Complex Spine, New York, NY. Early outcomes and complications of posterior vertebral column resection. Spine. 2013;15(5):983–91. doi: 10.1016/j.spinee.2013.03.023.

Suk SI, Kim JH, Kim WJ, Lee SM, Chung ER, Nah KH. Posterior vertebral column resection for severe spinal deformities. Spine. 2002;27(21):2374–82.

Shimode M, Kojima T, Sowa K. Spinal wedge osteotomy by a single posterior approach for correction of severe and rigid kyphosis or kyphoscoliosis. Spine. 2002;27(20):2260–7.

Smith JT, Gollogly S, Dunn HK. Simultaneous anterior-posterior approach through a costotransversectomy for the treatment of congenitalkyphosis. Bone Joint Surg. Am. 2005;87(10):2281–9.

Cho WJ, Kang CN, Park YS, Kim HJ, Cho JL. Surgical correction of fixed kyphosis. Asian Spine J. 2007;1(1):12–18. doi: 10.4184/asj.2007.1.1.12.

Spiro AS, Rupprecht M, Stenger P, Hoffman M, Kunkel P, Kolb JP, Rueger JM, Stuecker R. Surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach. Bone Joint J. 2013;95-B(11):1527–32. doi: 10.1302/0301-620X.95B11.31376.

Zeng Y, Chen Z, Qi Q, Guo Z, Li W, Sun C, Liu N. The posterior surgical correction of congenital kyphosis and kyphoscoliosis 23 cases with minimum 2 years follow-up. Eur Spine J. 2013;22(2):372–8. doi: 10.1007/s00586-012-2463-0.

Atici Y, Sökücü S, Uzümcügil O, Albayrak A, Erdoğan S, Kaygusuz MA. The results of closing wedge osteotomy with posterior instrumented fusion for the surgical treatment of congenital kyphosis. Eur. Spine J. 2013;22(6):1368–74. doi: 10.1007/s00586-013-2755-z.

Zhao H, Weng X, Qiu G, Ye Q. The surgical treatment of congenital kyphosis. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1999;21(2):146–50.

Bollini G, Docquier PL, Viehweger E, Launay F, Jouve JL. Thoracolumbar hemivertebrae resection by double approach in a single procedure long-term follow-up. Spine. 2006;31(15):1745–57.

Yang BH, Li HP, He XJ, Zhao B, Zhang C, Zhang T, Huang SH. Total vertebral column resection combined with anterior mesh cage support for the treatment of severecongenital kyphoscoliosis. Gu Shang. 2014;27(5):358-62.

Tsou PM. Embriology of congenital kyphosis. Clin Orthop Relat Res. 1987;128:18–25.

Wang Y, Lenke LG. Vertebral column decancellation for the management of sharp angular spinal deformity. Eur. Spine J. 2011;20(10):1703–10. doi: 10.1007/s00586-011-1771-0.

Noordeen MH, Garrido E, Tucker SK, Elsebaie HB. The surgical treatment of congenital kyphosis. Spine. 2009;34(17):1808–14. doi: 10.1097/BRS.0b013e3181ab6307




DOI: https://doi.org/10.15674/0030-598720164111-118

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