[Surgical treatment strategies for severe cervicothoracic kyphosis]

To analyze the outcomes of surgical treatment for severe cervicothoracic kyphosis.

A retrospective study was performed for a total of 7 patients with severe cervicothoracic kyphosis. There were congenital malformation (n = 5) and cervicothoracic tuberculosis (n = 2). The mean preoperative Cobb angle of kyphosis was 89.3° (range: 72 - 103°). The average JOA (Japanese Orthopedic Association) score of neurological function was 11.2 ± 1.2 points. Preoperative halo-pelvic traction was performed and maintained for 25 - 40 days according to the patient conditions. Then posterior instrumented fusion was performed.

The average postoperative JOA score was 15.4 ± 1.6 points. The mean immediate postoperative Cobb angle was 53.4° (range: 45 - 67°). A mean correction rate of 40.2% was achieved. All patients were followed up for a mean of 18 months (range: 10 - 24). And a mean correction loss of 2.5° was observed at the final follow-up. Two patients had transient upper limb pain during distraction. There were no intra-operative or post-operative occurrences of spinal cord injury and other neurological complications.

Halo-pelvic traction plus posterior spondylodesis may be a safe and effective therapy of severe cervicothoracic kyphotic deformity.