Abstract
Etiologies of cervical kyphosis are diverse and may include neuromuscular, degenerative, post-traumatic, neoplastic, and iatrogenic conditions as well as systemic conditions such as ankylosing spondylitis and rheumatoid arthritis.
Surgical correction should be considered if the patient does not respond to a nonoperative treatment or demonstrates evidence of progressive myelopathy, radiculopathy, or functional disability, such as inability to achieve horizontal gaze, tension-/kyphosis-induced myelopathy, neck pain due to head imbalance, or swallowing dysfunction related to head position. Surgical correction of cervical kyphosis is challenging and requires a clear understanding of the disease and the patient. The surgeon must be very comfortable with remobilizing the spinal column anteriorly and posteriorly, with vertebral artery anatomy and with methods of anterior and posterior correction. This chapter details the preoperative considerations and surgical procedures of two of the most common cervical osteotomies for cervical kyphosis: (1) Smith-Petersen osteotomy and the C7 subtraction osteotomy (PSO).
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References
Steinmetz MP, Stewart TJ, Kager CD, Benzel EC, Vaccaro AR. Cervical deformity correction. Neurosurgery. 2007;60(1 Supp1 1):S90–7.
Chi JH, Tay B, Stahl D, Lee R. Complex deformities of the cervical spine. Neurosurg Clin N Am. 2007;18(2):295–304.
Epstein NE. Evaluation and treatment of clinical instability associated with pseudoarthrosis after anterior cervical surgery for ossification of the posterior longitudinal ligament. Surg Neurol. 1998;49(3):246–52.
Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81(4):519–28.
Mason C, Cozen L, Adelstein L. Surgical correction of flexion deformity of the cervical spine. Calif Med. 1953;79(3):244–6.
Scheer JK, Tang JA, Deviren V, Acosta F, Buckley JM, Pekmezci M, et al. Biomechanical analysis of cervicothoracic junction osteotomy in cadaveric model of ankylosing spondylitis: effect of rod material and diameter. J Neurosurg Spine. 2011;14(3):330–5.
Chapman JR, Anderson PA, Pepin C, Toomey S, Newell DW, Grady MS. Posterior instrumentation of the unstable cervicothoracic spine. J Neurosurg. 1996;84(4):552–8.
Deviren V, Scheer JK, Ames CP. Technique of cervicothoracic junction pedicle subtraction osteotomy for cervical sagittal imbalance: report of 11 cases. J Neurosurg Spine. 2011;15(2):174–81.
Scheer JK, Tang JA, Buckley JM, Deviren V, Pekmezci M, McClellan RT, et al. Biomechanical analysis of osteotomy type and rod diameter for treatment of cervicothoracic kyphosis. Spine. 2011;36(8):E519–23.
Edwards CC 2nd, Riew KD, Anderson PA, Hilibrand AS, Vaccaro AF. Cervical myelopathy. Current diagnostic and treatment strategies. Spine J. 2003;3(1):68–81.
Mummaneni PV, Deutsch H, Mummaneni VP. Cervicothoracic kyphosis. Neurosurg Clin N Am. 2006;17(3):277–87. vi.
Mummaneni PV, Mummaneni VP, Haid RW Jr, Rodts GE Jr, Sasso RC. Cervical osteotomy for the correction of chin-on-chest deformity in ankylosing spondylitis. Technical note. Neurosurg Focus. 2003;14(1):e9.
Belanger TA, Milam RA, Roh JS, Bohlman HH. Cervicothoracic extension osteotomy for chin-on-chest deformity in ankylosing spondylitis. J Bone Joint Surg Am. 2005;87(8):1732–8.
Simmons ED, DiStefano RJ, Zheng Y, Simmons EH. Thirty-six years experience of cervical extension osteotomy in ankylosing spondylitis: techniques and outcomes. Spine. 2006;31(26):3006–12.
Suk KS, Kim KT, Lee SH, Kim JM. Significance of chin-brow vertical angle in correction of kyphotic deformity of ankylosing spondylitis patients. Spine. 2003;28(17):2001–5.
Daubs MD, Lenke LG, Cheh G, Stobbs G, Bridwell KH. Adult spinal deformity surgery: complications and outcomes in patients over age 60. Spine. 2007;32(20):2238–44.
Tang JA, Scheer JK, Smith JS, Deviren V, Bess S, Hart RA, et al. The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery. Neurosurgery. 2012;71(3):662–9. discussion 9.
Scheer JK, Tang JA, Buckley JM, Pekmezci M, McClellan RT, Ames CP. Biomechanical analysis of osteotomy type (OWO, CWO) and rod diameter for treatment of cervicothoracic kyphosis. 17th Annual International Meeting on Advanced Spine Techniques, Toronto, Canada; 2010.
Sansur CA, Fu KM, Oskouian RJ Jr, Jagannathan J, Kuntz C, Shaffrey CI. Surgical management of global sagittal deformity in ankylosing spondylitis. Neurosurg Focus. 2008;24(1):E8.
Etame AB, Than KD, Wang AC, La Marca F, Park P. Surgical management of symptomatic cervical or cervicothoracic kyphosis due to ankylosing spondylitis. Spine. 2008;33(16):E559–64.
Etame AB, Wang AC, Than KD, La Marca F, Park P. Outcomes after surgery for cervical spine deformity: review of the literature. Neurosurg Focus. 2010;28(3):E14.
Hoh DJ, Khoueir P, Wang MY. Management of cervical deformity in ankylosing spondylitis. Neurosurg Focus. 2008;24(1):E9.
Nottmeier EW, Deen HG, Patel N, Birch B. Cervical kyphotic deformity correction using 360-degree reconstruction. J Spinal Disord Tech. 2009;22(6):385–91.
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Osorio, J.A., Scheer, J.K., Southwell, D.G., Ames, C.P. (2019). Osteotomy for Cervical Kyphosis. In: Kaiser, M., Haid, R., Shaffrey, C., Fehlings, M. (eds) Degenerative Cervical Myelopathy and Radiculopathy . Springer, Cham. https://doi.org/10.1007/978-3-319-97952-6_34
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