Cervical kyphosis correction and clinico-radiographic outcome assessment: a single centre experience

Cervical kyphosis is a rare debilitating condition that leads to functional disability. Surgical correction of cervical kyphosis is challenging. Realistic goals and meticulous preoperative planning are crucial to achieving the desired outcomes.

To analyse the safety and efficacy of various surgical approaches, and clinical and radiographic outcomes following cervical kyphosis correction.

Retrospective study.

50 patients with cervical kyphosis who underwent deformity correction between 2008 and 2023 with 24-month follow-up.

Nurick's grading, mJOA, C2-7 sagittal Cobb angle, C2 slope, and T1 slope.

Baseline patient demographics, surgical characteristics, baseline and follow-up clinical (Nurick grading and mJOA), and radiographic outcome (C2-7 sagittal Cobb angle, C2 slope, and T1 slope) measures were collected from the database on admission and the latest follow-up. Radiographic parameters were studied on CT and cervical spine radiographs to assess stability, the degree of deformity correction, and fusion status at the latest follow-up.

A total of 50 patients with a mean age of 25.2 years were included. The mean kyphotic segment was 3.6. All underwent surgical correction using various approaches. Combined anterior and posterior approach (44%) was the predominant common approach followed by the posterior-only approach (42%). Twenty patients (40%) developed postoperative complications and nine patients (18%) had major Clavien-Dindo complications with a mortality rate of 4% in our cohort. There was a significant change in myelopathy from a baseline mJOA of 11.1-12.6 and a Nurick grade of 3.2-2.6 (p = < 0.01). There was a significant deformity correction with a reduction of kyphosis to the following: mean Cobb angle was 44.4°-9.5° (p = < 0.01), mean C2 slope was 39.1°-12.2° and mean T1 slope was 7.9°-7.9°. The mean follow-up was 75.1 ± 44.6 months. There were no new complaints on the latest follow-up.

Surgical management of severe cervical kyphosis should prioritize neural decompression, deformity correction, and spinal reconstruction. Surgical correction can achieve radiographic realignment and modest functional improvement, successfully halting neurological progression in most cases. Long-term surveillance remains essential given the prevalence of delayed complications (junctional kyphosis or implant failure).