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Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Kyphectomy for myelodysplasia
1Harvard Medical School, Boston, MA 02115, USA. lawrence.karlin@childrens.harvard.edu <lawrence.karlin@childrens.harvard.edu>
Neurosurgery Clinics of North America
|June 9, 2007
Summary
Surgical correction, including vertebrectomy and spinal instrumentation, effectively treats progressive kyphotic deformity in myelomeningocele patients. Less invasive techniques like vertebral body decancellation are being explored for younger children.
Area of Science:
- Pediatric Orthopedics
- Spinal Deformity Surgery
- Myelomeningocele Management
Background:
- Progressive kyphotic deformity affects 15% of children with myelomeningocele.
- Common complications include skin ulceration and seating issues.
- Surgical intervention is the primary treatment for this condition.
Purpose of the Study:
- To review surgical techniques for correcting kyphotic deformity in myelomeningocele.
- To evaluate the efficacy of vertebrectomy and spinal instrumentation.
- To explore alternative growth-sparing surgical methods.
Main Methods:
- Vertebrectomy of the deformity's cephalad limb for correction.
- Segmental spinal instrumentation for maintaining correction.
- Investigation of vertebral body decancellation as a less invasive alternative.
Main Results:
- Vertebrectomy offers excellent correction of kyphotic deformity.
- Segmental spinal instrumentation ensures superior maintenance of correction.
- Vertebral body decancellation shows potential for continued spinal growth in select patients.
Conclusions:
- Surgical correction is essential for managing myelomeningocele-related kyphosis.
- Vertebrectomy with instrumentation is a reliable treatment.
- Vertebral body decancellation is a promising option for younger patients with less severe deformities.
