Surgical treatment of kyphosis in children and adolescents

Oper Orthop Traumatol. 2023 Sep 13. doi: 10.1007/s00064-023-00828-4. Online ahead of print.ABSTRACTOBJECTIVE: 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 ...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Source Type: research