title: Cervical corpectomy and plate fixation for postlaminectomy kyphosis.
abstract: Between 1987 and 1991, 20 patients with symptomatic postlaminectomy kyphosis were treated with anterior decompression, bone graft, and anterior cervical plate. The patients were predominantly male (14:6) with a mean age of 58 years. The initial laminectomy was performed for either spondylosis (80%) or spinal tumor (20%). All patients had anterior compressive pathology, which was associated with instability (45%), neck pain (75%), myeloradiculopathy (90%), or severe neck deformity (30%). The mean degree of kyphosis was 38 degrees. Treatment consisted of a trial of cervical traction (75%), anterior corpectomy (95%), intersegmental decompression (5%), bone fusion (100%), and fixation with either Caspar (85%) or Synthes (15%) anterior plating at a mean of 3.8 levels. Halo fixation was used in 10% of patients. Postoperative complications included vocal cord paresis (15%), pneumonia (10%), wound dehiscence (5%), and screw pull-out (5%). At follow-up evaluation, a mean of 28 months after treatment, all patients had a solid fusion and a mean curvature improvement to 16 degrees residual kyphosis. Neurologically, 10% were cured, 55% were improved and returned to premorbid function, 30% were stable, and 5% had late progression. These data suggest that immediate fixation with anterior plating facilitates solid fusion, maintains spinal curvature, and promotes neurological improvement.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital, Phoenix, Arizona.
authors.forename: J M
authors.initials: JM
authors.lastname: Herman
authors.forename: V K
authors.initials: VK
authors.lastname: Sonntag
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D007796:Laminectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods; D013125:Spinal Neoplasms / Q000601:surgery; D013128:Spinal Osteophytosis / Q000601:surgery