[Surgical correction of post-traumatic kyphosis of thoracolumbar spine].
OBJECTIVE
To determine the effectiveness of surgical correction for post-traumatic kyphosis of thoracolumbar spine.


METHODS
From 1996 to 2003, 33 consecutive patients with post-traumatic kyphosis of thoracolumbar spine were corrected surgically. The mean age was 40.3 years (range, 13 - 65 years). The mean time between the initial injury and surgical correction was 36.0 months (range, 6 - 220 months). The kyphotic deformity averaged 40.8 degrees (range, 20 degrees - 82 degrees ). All the patients had neurological deficits. Twelve patients had obvious back pain. Seven patients lost sphincter function completely and nineteen patients lost the function partly. Twenty-three patients had ever undergone laminectomy and/or instrumentation. The treatment procedure consisted of anterior release and posterior spinal osteotomy with instrumentation (15 patients), posterior closing wedge osteotomy with instrumentation (12 patients), anterior release and instrumentation (6 patients).


RESULTS
Kyphosis was corrected from an average of 40.8 degrees to an average of 5.7 degrees, the corrective rate was 86.0% (40.8 degrees - 5.7 degrees /40.8 degrees). There were no severe complications. The average follow-up period was 24.6 months (range, 6 - 84 months). There was no loss of correction at follow-up. Ten of these patients showed an improvement in neural function by one or two levels according to the classification. Sphincter function recovered partly in ten patients. Back pain was relieved significantly in all of twelve patients with back pain preoperatively. Bony fusion was achieved in thirty-two patients. One patient had nonunion and achieved bony fusion after revision.


CONCLUSIONS
Posterior closing wedge osteotomy was suitable to kyphosis less than 40 degrees. Anterior release and posterior spinal osteotomy was effective, especially to the patients with severe kyphosis deformity or with operation history. Patients with incomplete neurological deficits and/or severe back pain could get benefit from osteotomy of spine, even if their medical history was long.
Chen
Zhong-Qiang
ZQ
Department of Orthopaedics, the Third Hospital of Peking University, Beijing 100083, China.
Li
Wei-Shi
WS
Guo
Zhao-Qing
ZQ
Qi
Qiang
Q
Dang
Geng-Ting
GT
D000293:Adolescent; D016025:Bone Transplantation; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome