Corrective spinal osteotomy for kyphotic deformity

ABSTRACT

We present sixteen cases of spinal kyphosis treated by a closing-wedge posterior vertebral osteotomy with partial corpectomy at the apex of the deformity followed by posterior stabilization and fusion. The deformity was caused by a congenital anomaly in 6 cases; infection in 7 cases; and ankylosing spondylitis in 3 cases. The indication for surgery was to correct a deformity, which interfered with sitting balance, disturbed respiration, caused abdominal discomfort and/or impeded forward sight vision ahead to the horizon. The average correction was 38 degrees [22-65 degrees] with a mean loss of correction of 3.9 degrees [0-12 degrees]. The average operating time was 195 minutes and blood loss was 1750cc. The osteotomy corrected the deformity in all the cases sufficiently to alleviate the pre-existing symptoms and improve their posture. There were no fatal complications. Implant failure was seen in 2 cases in the form of screws loosening. One deep seated infection required removal of the implant, and two cases had superficial infection controlled by local debridement and parentral antibiotics