Surgical staged treatment for moderate to severe adolescent cervical kyphosis

作     者：LIANG Lei ZHOU Xu-hui LIU Yang GAO Rui CHEN Hua-jiang YANG Li-li SHI Sheng YUAN Wen 

作者机构：Department of Spine Surgery Changzheng Orthopaedics Hospital the Second Military Medical University Shanghai 200003 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2011年第124卷第23期

页      面：3864-3867页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：This study was supported by the grants from the Innovation Program of Shanghai Municipal Education Commission (No.10ZZ54) 

主　　题：cervical vertebrae kyphosis staged treatment adolescent 

摘      要：Adolescent cervical kyphosis refers to manifestation characterized by loss of physiological cervical lordosis with involvement of multiple cervical vertebrae. There is no standard treatment strategy for this disease, especially in those patients who need surgical intervention. The aim of this study was to evaluate the surgical staged treatment for moderate to severe adolescents cervical kyphosis. Methods A total of 26 adolescent with cervical kyphosis were retrospectively assigned into following two groups according to the magnitude of kyphosis： moderate group （n=17）, the Cobb angle was 46.6°±4.8°. The surgical procedure was that skull traction was first carried out for 5-7 days and then the anterior fusion and instrumentation were performed. Severe group （n=-9）, the Cobb angle was 61.6°±4.8°. The treatment strategy was that the anterior release were first performed, followed by skull traction for 7-10 days, and then anterior fusion were performed. Radiographic evaluation was performed postoperatively. Results Three days after surgery, the X-ray examination showed that the Cobb angle was -8.9°±6.8° in the moderate group and -6.0°±6.3° in the severe group. The deformed appearance was obviously corrected, with neck pain and neurologic function improved significantly. Further magnetic resonance imaging （MRI） indicated the physiology curvature of the cervical spine had been reconstructed. Conclusion Surgical staged treatment may be an ideal therapeutic intervention for cervical kyphosis patients with a Cobb angle exceeding 35° in adolescents.