Circumferential fusion for cervical kyphotic deformity

Area of Science:

• Spine surgery
• Orthopedic surgery
• Neurosurgery

Background:

• Cervical kyphotic deformity presents a significant treatment challenge.
• Limited literature exists on combined anterior/posterior correction methods for cervical kyphosis, with infrequent reporting of fusion rates and standardized outcomes.

Purpose of the Study:

• To present midterm results of surgical correction for cervical kyphosis using a combined anterior and posterior approach.
• To evaluate fusion rates and functional outcomes in patients with cervical kyphotic deformity.

Main Methods:

• Retrospective review of 30 patients with cervical kyphotic deformity undergoing circumferential spine surgery (2001-2007).
• Causes included chronic fracture (17), degenerative disease (10), and tumor (3).
• Procedures involved anterior discectomies/corpectomies/osteotomies and posterior decompression/osteotomies with fixation. Outcomes assessed using Ishihara kyphosis indices, modified Japanese Orthopaedic Association (mJOA) scores, and Nurick grades.

Main Results:

• Follow-up in 27 patients ranged from 1 to 6.4 years (mean 2.6 years).
• Significant improvements observed in Ishihara kyphosis indices (mean -17.7 to +11.4), Nurick grades (mean 3.2 to 1.3), and mJOA scores (mean 10 to 15).
• A 95% fusion rate was achieved, with an overall complication rate of 33.3%.

Conclusions:

• Combined anterior and posterior surgery effectively restores cervical lordosis in cervical kyphosis.
• This surgical approach leads to significant improvements in neurological function and high fusion rates.
• A notable complication rate is associated with this treatment strategy.