[Surgical treatment strategies for severe cervicothoracic kyphosis].
OBJECTIVE
To analyze the outcomes of surgical treatment for severe cervicothoracic kyphosis.


METHODS
A retrospective study was performed for a total of 7 patients with severe cervicothoracic kyphosis. There were congenital malformation (n = 5) and cervicothoracic tuberculosis (n = 2). The mean preoperative Cobb angle of kyphosis was 89.3° (range: 72 - 103°). The average JOA (Japanese Orthopedic Association) score of neurological function was 11.2 ± 1.2 points. Preoperative halo-pelvic traction was performed and maintained for 25 - 40 days according to the patient conditions. Then posterior instrumented fusion was performed.


RESULTS
The average postoperative JOA score was 15.4 ± 1.6 points. The mean immediate postoperative Cobb angle was 53.4° (range: 45 - 67°). A mean correction rate of 40.2% was achieved. All patients were followed up for a mean of 18 months (range: 10 - 24). And a mean correction loss of 2.5° was observed at the final follow-up. Two patients had transient upper limb pain during distraction. There were no intra-operative or post-operative occurrences of spinal cord injury and other neurological complications.


CONCLUSIONS
Halo-pelvic traction plus posterior spondylodesis may be a safe and effective therapy of severe cervicothoracic kyphotic deformity.
Department of Orthopedics, Changzheng Hospital, Shanghai, China.
Jun
J
Ma
Lian-shun
LS
Jia
Jiang
J
Shao
Jia
J
Song
Xu-hui
XH
Zhou
D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000002:abnormalities; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000002:abnormalities; D016896:Treatment Outcome; D055815:Young Adult