Post-traumatic deformity: prevention and management

Traumatic spinal column injuries (SCI) can result in devastating deformities that often have long-term impact on the patient's quality of life. These deformities result in pain and occasionally neurological deficits. The deformities affecting adults often differ slightly from those in the pediatric population. In adults, injuries to the spinal column frequently result in a sagittal plane deformity, such as kyphosis or lordosis. However, in children, spinal cord injuries often cause coronal deformities, such as scoliosis. Patients with post-traumatic spinal column deformities may present acutely immediately after the injury, many years after the inciting event, or at any time in-between. Patients with post-traumatic spinal deformity initially complain of pain at the site of the deformity, but with time may complain of pain above or below the deformity as a result of degenerative changes. Any change or worsening of neurological status is a worrisome complaint, and often these patients require surgical intervention. Procedures such as fusions and spinal column osteotomies have shown promising results in treating patients with post-traumatic spinal deformities and have been shown to improve their quality of life.