Yao Ziming,Zhang Xuejun,Guo Dong,et al.Clinical outcomes and osteotomic strategies for congenital kyphosis in children[J].Journal of Clinical Pediatric Surgery,,20():19-23.[doi:10.12260/lcxewkzz.2021.01.004]
Clinical outcomes and osteotomic strategies for congenital kyphosis in children
- Keywords:
- Kyphosis/SU; Kyphosis/TH; Osteotomy; Treatment Outcome; Child
- CLC:
- R726.8;R682.3;R687.3+1
- Abstract:
- Objective To explore the clinical outcomes of surgical treatment for congenital kyphosis in children and examine the optimal osteotomy options for different congenital kyphosis.Methods From January 2010 to December 2017,clinical and imaging data of 48 children with congenital kyphosis undergoing posterior surgery were reviewed.There were 26 boys and 22 girls with an average age of (7.6±3.8)(2-16) years.Classification of kyphosis,osteotomy type and fixation level were recorded.On standing whole spinal X-rays at pre/post-operation and the last follow-up,segmental kyphosis (SK),thoracic kyphosis (TK),lumbar lordosis (LL) and sagittal vertical axis (SVA) were measured.The intra-operative and post-operative complications were recorded.Results The average follow-up was (37.9±10.2)(24-108) months.The clinical types were Ⅰ (n=19),Ⅱ (n=16) and Ⅲ (n=13).The procedures included Ponte osteotomy (n=9),intervertebral osteotomy (n=5),pedicle subtraction osteotomy (PSO,n=13),SRS-Schwab grade 4 osteotomy (n=8) and vertebra column resection (VCR,n=13).Preoperatively,the values of SK,TK,LL and SVA were (52.3±14.3)°,(11.2±13.7)°,(33.2±14.3)° and (21.9±13.6) mm;at Month 1 post-operation,SK,TK,LL and SVA were corrected to (20.0±12.1)°,(26.8±10.0)°,(43.5±10.4)?nd (-24.0±19.1) mm.At the last follow-up,SK,TK,LL and SVA were (19.4±13.4)°,(23.9±6.0)°,(41.9±9.4)° and (-17.6±15.3) mm respectively.All children stayed stable during follow-ups.One patient suffered partial progression and another had coronal proximal Adding-on.Neither underwent revision.There was no neurologic complication.Conclusion Congenital kyphosis may be corrected effectively by osteotomy with fewer complications.Optimal osteotomy option depends upon kyphotic type and degree.For type Ⅰ kyphosis,Ponte osteotomy,SRS-Schwab Grade 4 osteotomy or VCR is performed;for type Ⅱ kyphosis,intervertebral osteotomy,PSO or SRS-Schwab grade 4 osteotomy;for type Ⅲ kyphosis,PSO or SRS-Schwab Grade 4 osteotomy.
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Memo
收稿日期:2020-12-05。
基金项目:国家重点研发项目（编号：2016YFC1000806）
通讯作者:张学军,zhang-x-j04@163.com