gms | German Medical Science

Objective: To study clinically significant outcomes following correction of complex cervical kyphosis with myelopathy.

Method: Retrospective study. We analyzed seventeen patients who underwent surgical correction of complex cervical kyphosis in our center operated by a single surgeon between March 2011 & October 2014. Our study group included patients with different etiologies for cervical kyphosis (infectious, degenerative, oncological and traumatic). Mean age was 59 years (range 38-76). We compared preoperative and postoperative principle cervical spine deformity radiological measurements. These were: Sagittal alignment (angle between the superior endplate of C3 to the inferior endplate of C7 on a lateral X-Ray), kyphotic angle (measured on lateral X-Ray in the neutral position between the posterior margins of the most caudal and cranial vertebral bodies forming the maximal kyphosis), Cobb's angle, and head translation (the distance between the posterior aspect of the dens and a vertical axis drawn from the posterior caudal aspect of C7 vertebral body). The study compared results in relation to spinal levels included in fusion and surgical approach as well.

Results: The mean and standard deviation of correction achieved were, respectively: for sagittal alignment 15.1 ± 10.86, for Cobb's angle 15.7 ± 11.22, for kyphotic angle 23.8 ± 11.88, for head translation 1.97 ± 1.25, and for vertebral levels included in correction 4.5 ± 1.96. Interestingly head translation increased on average by 2 cm anteriorly, which was against our expectations. Relevant correction of measurements was achieved when more levels were fused.

Conclusions: Success of cervical spine kyphosis correction appears to have a more relevant relation to levels of correction included. Following successful correction measured by standard parameters (Sag.Alignment, Kyphotic angle and Cobb's Angle) the head is translated anteriorly, which is a surprising, however consistent result. We hope these result will encourage more studies of this common and not well-studied spine condition, which affects a large segment of aging populations.