Management of Rigid Post-traumatic Kyphosis

Abstract

This method provides single-stage posterior decompression, correction, and stabilization on as definitive management for post traumatic kyphosis of the thoracolumbar and lumbar spine.

Three-stage surgery in the management of severe rigid angular kyphosis

“…The average length of hospitalization was 14 days (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

“…Posterior osteotomies have been widely used for this purpose. Various techniques consisting of partial and total posterior wedge osteotomies have previously been described [3,8,9,11,14,15,16,18]. The apex of the correction axis lies in the anterior surface of the corpus in posteriorly placed osteotomies.…”

“…Furthermore, folding of the spinal cord and impinging between the laminae increase the risk of neurological injury. Posterior corrective osteotomies are reported to result in corrections of between 20°and 55° [3,8,9,11,14,15,16,18]. Anterior resection and distraction results in a posterior displacement of the fulcrum of the correction axis.…”

“…Some of them attempt to solve the problem by posterior wedge osteotomies [3,8,9,11,14,15,16,18], while others have preferred combined procedures [2,5,6,7,10,13]. Favourable results have been attained by all these techniques for the correction of deformities not exceeding 50°-60°.…”

Posterior spinal shortening for paraparesis following vertebral collapse due to osteoporosis

“…A similar procedure has been performed in ankylosing spondylitis or posttraumatic kyphosis, and excellent results have been reported without neurological deterioration. [17][18][19] We adapted the posterior spinal shortening to control the direction of force applied to the implant by changing spinal curvature. When a fracture of the vertebra at the ends of fixation occurred, instruments were dislocated.…”