Cervical Kyphotic Deformity Correction Using 360-degree Reconstruction

Abstract

The authors report on their experience with cervical sagittal deformity correction using 360-degree reconstruction. A paucity of literature exists concerning 360-degree approaches for the correction of cervical kyphotic sagittal deformity in which the amount of deformity correction achieved, as well as the maintenance of deformity correction, is detailed. The charts of all patients undergoing 360-degree cervical reconstruction for kyphotic sagittal plane deformity between 2000 and 2006 at Mayo Clinic Jacksonville and Mayo Clinic Scottsdale were retrospectively reviewed. Only patients with a minimum of 1-year follow-up were included in this study; 41 patients fit this criterion. The clinical data were further analyzed in this cohort to determine preoperative and postoperative sagittal angle, loss of correction, fusion rate, complications, and clinical status at last follow-up. Average follow-up was 19 months (range: 12 to 48 mo). The mean preoperative sagittal angle was 18 degrees of kyphosis (range: 3 to 58 degrees). The mean correction of sagittal angle was 22 degrees (range: 4 to 56 degrees), resulting in a postoperative mean sagittal angle of 4-degree lordosis. There was no loss of correction across the instrumented segments in any patient. Neurologic complications included 1 case of quadriparesis and 1 case of transient C8 radiculopathy. The correction of cervical kyphotic sagittal plane deformity can be accomplished safely and effectively using a 360-degree approach. The incidence of major complications in this study was low. All patients could be corrected to a neutral or lordotic alignment. No loss of deformity correction was seen in any patient, and a 97.5% fusion rate was obtained.