title: Circumferential fusion for severe post surgical cervical kyphosis.
abstract: Cervical kyphosis-though a common occurrence after surgery and other conditions like trauma, infections, etc., is usually restricted to around 20-40°. It is more common in children. Angulations of more than 70-80° are exceedingly uncommon and present more treatment challenges. We discuss here the management of a 14-year-old child with a severe postoperative cervical kyphotic angulation of 92°. The child presented 10 months after surgery for a C3-C4 intramedullary cyst with neck deformity and near tetraplegic state. He underwent a combined anterior-posterior approach for correction after a trial of skull traction. Six months after the surgery, the child was ambulatory with almost total correction of the deformity. Surgical correction of postoperative cervical kyphosis usually involves a posterior approach for small angles and an anterior approach for larger angulations. The combined anterior-posterior approach is preferred for severe angulations or for those cases not correctable by a single approach. A purely posterior approach may be the only option for those cases where the anterior approach is impossible.
authors.affiliation: Department of Neurosurgery, King Georges Medical University, Lucknow, India.
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Singh
authors.affiliation: Department of Neurosurgery, King Georges Medical University, Lucknow, India.
authors.forename: Chhitij
authors.initials: C
authors.lastname: Srivastava
authors.affiliation: Department of Neurosurgery, King Georges Medical University, Lucknow, India.
authors.forename: Bal Krishna
authors.initials: BK
authors.lastname: Ojha
authors.affiliation: Department of Neurosurgery, King Georges Medical University, Lucknow, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Chandra
keywords: Cervical kyphosis; circumferential fusion; postoperative