Kyphectomy in meningomyelocele children: surgical technique, risk analysis, and improvement of kyphosis.
OBJECTIVE
Kyphosis is a major complication of spina bifida, causing skin ulcers and osteomyelitis. This study examined the clinical and surgical characteristics of eight patients who underwent surgery, as well as improvement of their postoperative kyphosis angulations.


METHODS
The authors reviewed eight cases submitted to surgery between 2006 and 2010. Surgical intervention was indicated for osteomyelitis and recurrent ulcers at the curvature apex. Osteotomies and spine stabilization were performed. The patients' clinical characteristics were analyzed, as were the surgical techniques employed, variables of surgical complications, and angle range of the kyphosis deformity postcorrection.


RESULTS
There were no deaths. The average age at the time of surgery was 11 years old. The level of neurological injury was T10 in four patients and T12 in four. Average amount of bleeding during surgery was 1,442 ml, (range, 340 to 3,200 ml). Improvement of kyphosis angle was evident in all patients. The average difference between preoperative and postoperative kyphosis angle was 63.2.


CONCLUSIONS
Surgery performed by a multidisciplinary team minimizes risks. Despite the high number of complications published in the literature, the results found in this study were excellent with regards to improving kyphosis angle, as well as facilitating rehabilitation and daily care of children.
SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil. ricardogepp@zipmail.com.br.|, SQSW 300 bloco D apt 104 Sudoeste, Brasília, Cep 70673-014, Distrito Federal, Brazil. ricardogepp@zipmail.com.br.
Ricardo
R
de Amoreira Gepp
SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil.
Marco Rolando Sainz
MR
Quiroga
SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil.
Cícero Ricardo
CR
Gomes
SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil.
Hugo José
HJ
de Araújo
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000534:rehabilitation*; D019635:Neurosurgical Procedures; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D010348:Patient Care Team; D011183:Postoperative Complications; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome
Kyphosis; Meningomyelocele; Spinal cord; Surgery