Surgical staged treatment for moderate to severe adolescent cervical kyphosis

Background Adolescent cervical kyphosis refers to manifestation characterized by loss of physiological cervical lordosis with involvement of multiple cervical vertebrae. There is no standard treatment strategy for this disease, especially in those patients who need surgical intervention. The aim of this study was to evaluate the surgical staged treatment for moderate to severe adolescents cervical kyphosis. Methods A total of 26 adolescent with cervical kyphosis were retrospectively assigned into following two groups according to the magnitude of kyphosis: moderate group (n=17), the Cobb angle was 46.6 degrees +/- 4.8 degrees. The surgical procedure was that skull traction was first carried out for 5-7 days and then the anterior fusion and instrumentation were performed. Severe group (n=9), the Cobb angle was 61.6 degrees +/- 4.8 degrees. The treatment strategy was that the anterior release were first performed, followed by skull traction for 7-10 days, and then anterior fusion were performed. Radiographic evaluation was performed postoperatively. Results Three days after surgery, the X-ray examination showed that the Cobb angle was -8.9 degrees +/- 6.8 degrees in the moderate group and -6.00 degrees +/- 6.30 degrees in the severe group. The deformed appearance was obviously corrected, with neck pain and neurologic function improved significantly. Further magnetic resonance imaging (MRI) indicated the physiology curvature of the cervical spine had been reconstructed. Conclusion Surgical staged treatment may be an ideal therapeutic intervention for cervical kyphosis patients with a Cobb angle exceeding 35 in adolescents. Chin Med J 2011;124(23):3864-3867