Vertebral excision for kyphosis in children with myelomeningocele

For twenty-three children with myelomeningocele, three types of operations, all including vertebral-body excision, were done to decrease and stabilize the kyphosis: (1) excision of the apical vertebra and a portion of the neighboring vertebra was done in five patients; (2) excision of the apical vertebra and of one or more vertebrae on each side of it, in eight patients; and (3) partial resection of the apical vertebra and of the proximal lordotic curve, in twelve patients. Loss of correction and increase of the kyphotic prominence equal to or greater than preoperative levels were encountered after the first two operations. The third operation provided persistent correction and the remaining lumbar vertebrae then continued to grow, increasing the capacity of the abdominal cavity.