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. 2015 Dec 7;44(6):513-8.
doi: 10.1016/S2255-4971(15)30150-6. eCollection 2009 Jan.

MULTIPLE SEGMENTAL OSTEOTOMIES TO THE KYPHOSIS CORRECTION

Carlos Fernando Pereira da Silva Herrero  1 , Maximiliano Aguiar Porto  1 , Marcello Henrique Nogueira Barbosa  2 , Helton Luiz Aparecido Defino  3
Affiliations

MULTIPLE SEGMENTAL OSTEOTOMIES TO THE KYPHOSIS CORRECTION

Carlos Fernando Pereira da Silva Herrero et al. Rev Bras Ortop. .

Abstract

Objective: To evaluate the results of the surgical treatment of the spinal Kyphosis using the Ponte's technique (multiple posterior osteotomies).

Methods: Ten patients (8 with Scheuermann's kyphosis and 2 with kyphosis after laminectomy) submitted to surgical correction of kyphotic deformity greater than 70° were retrospectively assessed. The age at the surgical time ranged from 12 to 20 years old (mean age16.8 years ± 2.89). The radiographic parameters evaluated were the kyphosis, the lordosis and the scoliosis - whenever present. The presence of proximal and distal junctional kyphosis, loss of correction, and complications as implants loosening and breakage were also assessed. The radiographic parameters were evaluated at the preoperative, early postoperative and late postoperative time.

Results: The patients were followed through a period that ranged from 24 to 144 months (65.8 ±39.92). The mean value of the kyphosis was 78.8° ± 7.59° (Cobb) before surgery and 47.5° ± 12.54° at late follow up, with mean correction of 33.9° ± 9.53° and lost correction of 2.2°.

Conclusion: The surgical treatment of the thoracic kyphosis using multiples posterior osteotomies presented a good correction of the deformity and minimal lost of correction during follow up.

Keywords: Kyphosis; Osteotomy; Scheuermann disease; Spinal fusion; Spine.

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Figures

Figure 1
Figure 1
Patient No. 7 in Table 1. A and B) Preoperative photographs evidence increased kyphosis. C) Profile radiograph evidences thoracic hyperkyphosis. D) Image showing postoperative correction of kyphosis. E and F) Profile and AP radiographs showing the correction of kyphosis.
Figure 2
Figure 2
Patient No. 2 in Table 1. Preoperative clinical (A and B) and radioscopic (C and D) appearance. Intraoperative photograph (E) illustrating the osteotomies. Radiological (F and G) and clinical (H) appearance demonstrating the correction.
Figure 3
Figure 3
Chart showing the mean angular kyphosis values in the preoperative, immediate postoperative, and late postoperative periods.
Figure 4
Figure 4
Patient No. 1 in Table 1. Photograph (A) and radiographs (B and C) showing preoperative kyphosis and associated scoliosis. Intraoperative photograph (D and E) illustrating multiple osteotomies and final correction. Clinical (F) and radiographic (G and H) appearance demonstrating the correction of kyphosis.
Figure 5
Figure 5
Patient No. 3 in Table 1. Photographs (A and B) and radiographs (C and D) showing increased preoperative kyphosis and the presence of scoliosis. Clinical (E and F) and radiographic (G and H) appearance postoperatively showing the correction of deformities.
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