Surgical treatment of cervical kyphosis

Surgical treatment of cervical kyphosis

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Ke Han • Chang Lu • Jing Li • Guang-Zhong Xiong • Bing Wang • Guo-Hua Lv • You-Wen Deng
  • چاپ و سال / کشور: 2010

Description

Cervical kyphosis is an uncommon but potentially debilitating and challenging condition. We reviewed the etiology, presentation, clinical and radiological evaluation, and treatment of cervical kyphosis. Based on the current controversy as to the ideal mode of surgical management, we paid particular attention to the available surgical strategies. There are three approaches for cervical kyphosis: the anterior, posterior or combined procedures. The principal indication for the posterior strategy is a flexible kyphosis or kyphosis caused by ankylosing spondylitis. The main point of debate is between the choice of the anterior or the combined strategy. The two strategies were compared with regard to clinical outcome, correction of deformity, rate of fusion, complications, revision surgery, and mortality. The combined strategy appears to result in a greater degree of correction than the anterior-alone strategy, and it is more likely to improve the cervical alignment to achieve a lordosis. However, the procedure carries a higher rate of postoperative neurological deterioration, complications, revision surgery, and mortality. Although the anterioralone strategy achieves a smaller reduction of cervical kyphosis, it has a lower rate of postoperative neurological deterioration, complications, revision surgery, and mortality. We recommend that the surgical treatment of cervical kyphosis should be planned on an individual basis. A multicenter, prospective, randomized controlled study would be necessary to determine the ideal mode of treatment for complex cervical kyphosis.
Eur Spine J (2011) 20:523–536 DOI 10.1007/s00586-010-1602-8 Received: 27 May 2010 / Revised: 30 August 2010 / Accepted: 29 September 2010 / Published online: 22 October 2010
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