Kyphotic Deformities of the Cervical Spine: Retrospective Study of 90 Patients

Petr Nesnidal, MD1, Jan Stulik1, Jan Kryl, MD1, Tomas Vyskocil, MD1, Michal Barna, MD1

1Prague, Czech Republic

Keywords: kyphosis, outcome, cervical spine, technique, spinal instrumentation

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Abstract

      
     The development of a cervical kyphotic deformity can be associated with a degenerative disease, trauma, tumour, systemic diseases, such as ankylosing spondylitis or rheumatoid arthritis , developmental anomaly and also a surgical procedure, both anterior and posterior surgical approaches.
     In our study were included 90 of 102 patients that underwent correction of cervical kyphosis at our department between 5/2005 and 4/2010 with average age of 56.7 years.
     All patients were examined before surgery by radiography, CT scanning and magnetic resonance imaging. Surgery was carried out from the anterior, posterior approach, or combined approach. The surgical outcome was assessed using the Nurick score and Neck Disability Index (NDI), the Visual Analogue Scale (VAS) was used to evaluate pain intensity or paraesthesia.
     The average NDI value was 25.5 before surgery and 14.3 and 14.9 at one and two years after surgery. The average pre-operative Nurick score was 0.7; an average post-operative value of 0.6 and 0,6. The average VAS value for neck and radicular pain was 5.7 pre-operatively, and 2.5 and 2.7, respectively. Complete bone union was achieved at 6 months after surgery in 97.8% patients. The average pre-operative value for the cervical curvature index (Ishihara) was -13.7, postoperatively +15.3. The average pre-operative cervical kyphosis was -14.4 degrees, postoperatively +13.5.
     This is a retrospective study.
     The results showed a marked improvement in the patients'' quality of life after kyphosis correction, improved neurological status and an improved posture seen on radiograms of the cervical spine.
     The study also revealed a higher number of potential complications associated, in particular, with corrective osteotomy. The best results were achieved with the combined surgical approach; however, the choice of a surgical method was independent on the patient''s clinical status.


Acknowledgements

Project Roles:

P. Nesnidal (), J. Stulik (), J. Kryl (), T. Vyskocil (), M. Barna ()