Zhang Hanwen,Yao Ziming,Guo Dong,et al.Challenges and experiences of managing cervical kyphosis in children:a single-centre retrospective summary of 16 cases[J].Journal of Clinical Pediatric Surgery,,22():1021-1028.[doi:10.3760/cma.j.cn101785-202307020-004]
Challenges and experiences of managing cervical kyphosis in children:a single-centre retrospective summary of 16 cases
- Keywords:
- Kyphosis; Congenital Abnormalities; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the clinical characteristics and surgical efficacies of children with cervical kyphosis (CK) and improve its therapeutic efficiency.Methods The relevant clinical data were retrospectively reviewed for 16 CK children operated from January 2013 to January 2023.The causes of deformity,imaging characteristics,surgical approaches and outcomes were summarized.Results There were 7 boys and 9 girls with a mean age of (8.2±4.7)(11/12-15.75) year.The underlying causes were congenital (n=9),NF-1 (n=3),tuberculosis (n=2),medical (n=1) and traumatic (n=1).All procedures were successfully completed without no serious perioperative complications.The procedures included simple anterior surgery of ACDF/ACCF+ASDI (n=9),combined 1-stage anterio-posterior surgery (n=6) and simple posterior hemilaminectomy plus pedicle fixation & fusion (n=1).Mean preoperative CK was 47.0(43.0±55.5)°,mean postoperative kyphosis 6.5(0,15.8)° and mean kyphosis 9.5(6.5,13.3)° at the last follow-up.During 3-month follow-ups,bony fusion was achieved after internal fixation in operative area.Postoperative and final follow-up posterior convexity was significantly better than preoperative (Z=-4.836,P<0.001; Z=-4.829,P<0.001) and there was no significant loss of correction (Z=-1.593,P=0.111).During follow-ups,there were distal junctional kyphosis (DJK,n=6) and adjacent segment disease (ASD,n=3).All of them attained ASIA grade E at the final follow-up.Conclusions CK in children is a rare clinical entity with decent outcomes when treatment is individualized according to its cause and local deformity.However,cautions should be taken against the development of ASD and DJK.
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Memo
收稿日期:2023-7-11。
基金项目:中央高水平医院临床科研业务费资助(2022-PUMCH-D-004)
通讯作者:张学军,Email:zhang-x-j04@163.com