Abstract

Objective To explore the rational individualized surgical procedure to treat nontraumat-ic and noninflammatory long-segment severe cervical kyphotic deformity in adolescent patients. Methods A retrospective review was made in 12 patients who suffered from long-segment severe cervical kyphotic defor-mity aged 12-19 years from July 2000 to July 2007. The common features in imaging materials were: 1.the top vertebra of kyphosis locating at C4or C5. 2. the vertebrae within the kyphotic curve wedged and interver-tebral space narrowing. 3. MRI showing spinal canal stenosis and dural compression at the top of kyphotic curve. The individual imaging characteristics as following: 1. C1-C2 rotary subluxation in 2 patients. 2. C2 an-terior subluxation in 2 patients. 3. C4-C7 vertebral severe malnutrion in 2 patients. 4. C2-C5 vertebral severe malnutron in 1 patient. 5. C6-C7 disc anteriorly open like trumpet mouth in 2 patients. Results Anterior approach alone in 2 patients, posterior approach alone in 2 patients, posterior approach combined with ante-rior approach in 7 patients, anterior-posterior-anterior approach in 1 patient. The kyphotic angle was correct-ed from average 73 degree to 15 degree. The follow-up duration was 3 months to 6 years, a new kyphosis occurred below the fused segment in 1 patient who was undergone anterior correction alone. The correction rate was not lost in the other 11 patients. The neurological function restored to normal level in 3 incomplete paraplegic patients. Conclusion Individualized surgical approach should be taken to treat long-segment se-vere cervical kyphotic deformity in adolescent patients because the pathogenesis, the degree of deformity, the secondary pathological change are different in every patient. Key words: Adolescent; Cervical vertebrae; Kyphosis; Clinical protocols

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