Surgical treatment of post-traumatic kyphosis: a report of 16 cases

Thoracic and lumbar spine fractures may lead to symptomatic progressive kyphosis for which surgery remains a controversial treatment. Sixteen patients with kyphosis were treated surgically at the Sacré-Coeur Hospital in Montreal between 1979 and 1985. The mean follow-up was 38 months. Initially, treatment of the fractures varied. On average the post-traumatic kyphosis was surgically corrected 34 months later. The corrective procedure consisted of staged anterior and posterior fusion with instrumentation (six patients), posterior fusion with instrumentation (five), staged anterior fusion, posterior osteotomy and fusion with instrumentation (four), posterior osteotomy and fusion with Harrington instrumentation (one). Anterior decompression was also performed in 5 of the 10 patients who had anterior fusion. There was no major perioperative complication. Pain was relieved in 13 patients and 9 of 11 had substantial neurologic improvement. Two patients had nonunion of posterior grafts, but these united after revision. The mean loss of correction in the early postoperative period was 3.5 degrees. The authors conclude that surgical treatment of post-traumatic symptomatic progressive kyphosis is effective and safe.