The results of closing wedge osteotomy with posterior instrumented fusion for the surgical treatment of congenital kyphosis

Abstract

There exist not much data regarding the surgical treatment of pure congenital kyphosis (CK) in the literature. The purpose of this study was to evaluate the results of closing wedge osteotomy with posterior instrumented fusion in patients with congenital kyphotic deformity. We retrospectively evaluated the radiographical results of 10 patients who were subject to closing wedge vertebral osteotomy and posterior instrumented fusion due to CK. The mean age of the patients at surgery was 12.6 ± 3.72 years (range 8-18 years). Radiographical measurements including local kyphosis, correction loss, global kyphosis and sagittal balance values were noted for the preoperative, postoperative and final follow up periods, respectively. The data obtained from those periods underwent statistical analysis. Average follow-up period was 51.8 ± 29.32 months (range 26-96 months). The mean local kyphosis angle was 67.7° ± 15.64° (range 42°-88°) prior to the surgery, 31.5° ± 17.12 (range 14°-73°) following the surgery and 31.9° ± 15.98° (range 14°-71°) during the follow up-period, respectively (p < 0.05). A correction rate of 53.5 % was reported at the final follow up. Average sagittal balance was measured as 33.1 ± 24.48 mm (range 2-77 mm) prior to the surgery, 20.8 ± 15.46 mm (range 5-46 mm) following the surgery (p < 0.05) and 14.1 ± 9.2 mm (range 0-30 mm) during follow-up period (p > 0.05). Complications consisted of a rod fracture due to pseudoarthrosis, an implant failure with loosening of screws and a proximal junctional kyphosis. No neurological deficit or deep infection were encountered in any of the patients in the study group. Closing wedge osteotomy with posterior instrumented fusion is an efficient method of surgical treatment in terms of sagittal balance restoration and deformity correction in patients with congenital kyphosis.