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Irradiation induced kyphosis.

E J Riseborough

    Clinical Orthopaedics and Related Research
    |October 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Irregular radiation doses during Wilms tumor treatment caused skeletal deformities in 70% of patients. Scoliosis and kyphosis were common, with some requiring surgical correction for severe spinal issues.

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    Area of Science:

    • Pediatric Oncology
    • Radiation Oncology
    • Orthopedic Surgery

    Background:

    • Wilms tumor is a common pediatric kidney cancer.
    • Treatment often involves irradiation and chemotherapy.
    • Axial skeletal deformities are a known complication of spinal irradiation.

    Purpose of the Study:

    • To investigate the relationship between radiation dose variation and axial skeletal deformities in Wilms tumor patients.
    • To analyze the types and severity of spinal deformities observed.
    • To evaluate surgical outcomes and preferred fusion techniques.

    Main Methods:

    • Retrospective study of 81 patients with Wilms tumor treated with irradiation and chemotherapy.
    • Analysis of radiation delivery techniques and dose distribution to the vertebral bodies.

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  • Assessment of spinal alignment and classification of deformities (scoliosis, kyphosis).
  • Review of surgical interventions and fusion methods for severe deformities.

    • Main Results:

    • 70% of patients developed axial skeletal deformities due to variable irradiation doses.
    • Scoliosis (32 patients) and kyphoscoliosis (22 patients) were the most frequent deformities.
    • 12 patients had kyphosis >25 degrees, with 7 requiring surgical correction.
    • High pseudarthrosis rates after posterior fusion favored a 2-stage anterior-posterior fusion approach.

    Conclusions:

    • Variations in delivered radiation dose are a significant cause of spinal deformities in Wilms tumor patients.
    • Spinal deformities require careful monitoring and management, often necessitating surgical intervention.
    • A 2-stage fusion procedure is preferred for managing severe spinal deformities and reducing pseudarthrosis risk.