Heyde CE, von der Höh N, Völker A. [Surgical treatment of kyphosis in children and adolescents].
OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2024;
36:33-42. [PMID:
37704775 DOI:
10.1007/s00064-023-00828-4]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE
Correction of a pathological kyphosis to restore a balanced, low-pain or pain-free and load-bearing spine.
INDICATIONS
Pronounced sagittal imbalance, progressive kyphosis despite conservative therapy, and neurological deficits are indications for surgery. Further surgical indications are severe therapy-resistant complaints and/or psychologically burdening cosmetic impairment. The guidelines for surgical indications are kyphosis angles of 75-80° thoracic and 30-50° lumbar.
CONTRAINDICATIONS
No specific, but general contraindications for surgical treatment.
SURGICAL TECHNIQUE
Depending on the characteristics of the kyphosis, different surgical techniques are used. Rod-screw systems are mainly used, and surgery is primarily performed by shortening the spinal column from posterior using a wide variety of techniques. In individual cases, this can be combined with ventrally mobilizing, resecting, or straightening techniques.
POSTOPERATIVE MANAGEMENT
The aim of surgical treatment is to achieve a primarily stable and weight-bearing spine. Regular wound control as well as stabilizing physiotherapy during follow-up are essential. Postoperatively, initially abstaining from sports; later physical activity is encouraged under professional guidance.
RESULTS
The literature shows very good corrective results in children and adolescents. The technical procedures are associated with a low and acceptable complication rate. Over the course of time, these patients must be monitored in order to detect possible long-term complications such as junctional kyphosis or pseudarthrosis.
Collapse