Pediatric Cervical Kyphosis: A Retrospective Multicenter Analysis and Literature Review

Area of Science:

• Pediatric Orthopedics
• Spine Surgery
• Cervical Spine Deformities

Background:

• Pediatric cervical kyphosis is increasingly recognized, with unique pediatric-vs-adult anatomical differences.
• Causes are diverse, including syndromes and iatrogenic factors, posing management challenges.
• Associated symptoms often include neck pain and myelopathy.

Purpose of the Study:

• Investigate pediatric cervical kyphosis, focusing on sagittal alignment.
• Compare pediatric and adult cervical sagittal alignment.
• Analyze management strategies and outcomes in a Middle Eastern cohort.

Main Methods:

• Retrospective analysis of 17 pediatric patients (2009-2021) across three Middle Eastern spine centers.
• Data collection included demographics, clinical information, and imaging.
• Literature review on pediatric cervical kyphosis and its management.

Main Results:

• Mean age at presentation was 11.9 years; 14 patients had surgery, 1 received bracing, and 2 were observed.
• Mean follow-up was 32.4 months.
• Combined anterior-posterior surgery yielded significantly better correction than standalone anterior or posterior surgery (P=0.014).

Conclusions:

• Pediatric cervical kyphosis, though rare, is a significant deformity often associated with syndromes or iatrogenic causes.
• Neck pain and myelopathy are common symptoms necessitating comprehensive evaluation.
• Complex surgical interventions are often required, with combined approaches showing superior outcomes.