Surgical treatment of thoracolumbar Kyphosis using combined anterior and posterior approaches

ABSTRACT

Between May 2002 and June 2005,27 patients with thoracolumbar kyphosis were selected for surgical treatment by both anterior approach that facilitated debridement,release,correction of the deformity and bone grafting followed by posterior transpedecular fixation and posterolateral fusion in the same sitting.In the current study,15 [56%] patients were suffering from post-traumatic kyphosis [Gl] while 12 [44%] patients were affected by postinfection kyphosis [G2].The kyphosis angle ranged from [30°-80°] with a mean of 42.2°.Follow up and evaluation by clinical and radiographic methods continued for a maximum of 36 months.Evaluation was based on the Denis pain and Work scale [PW] and on the new Frankel grading system. In group [l],the mean correction of the kyphosis angle was 33.9.This means that the correction was 76.2% of the deformity which is highly significant [p=0.01]. In group [2] the mean correction was 31.2 which is 74.2% of the deformity [p=0.01]. Marked neurological improvement was obtained postoperatively based on the modified Frankel grading system. In group [l], 67% of the patients were less than grade [Dl] and 33% were grade [E].In group [2],42% of the patients were grade [A] and [B] while 58% were grade [C]. All patients has improved to grade [E],with full motor and sensory functions