Pre-correction with cervical spine traction and surgical correction for the treatment of severe cervical kyphosis

English Keywords:Severe cervical spine kyphotic deformity  Pre-correcting traction  Fusion  Internal fixation

English Abstract:

  【Abstract】 Objectives: To investigate the efficacy and significance of pre-correction with cervical spine traction in the treatment of severe cervical spine kyphosis by using retrospective analysis of surgical results. Methods: Retrospective study of patients with severe cervical spine kyphosis(Cobb>40°) who were treated in our hospital from March 2003 to March 2017. In this series, 32 cases with 24 males and 8 females, who were 19.5±12.2 years old on the average(5.9-63.4 years), were included. According to the use of cervical spine traction prior to correction surgery, the cases were divided into traction group and no traction group. There were 26 cases in traction group. In those, 4 cases underwent skull traction and 22 cases had cervical spine suspended traction before final surgical correction. Six cases had surgical releasementprior to traction. There were 6 cases in the notraction group. The cervical kyphosis angle and JOA(Japanese Orthopedic Association) score were recorded at the admission, post-traction, discharge and follow-up. Results: In this series, the average kyphotic Cobb angle was 73.5°±26.5° and 16.6°±17.2°(P<0.05) before and after surgical correction, respectively. The final correction rate was (79.8±19.0)%. The JOA score improved from 11.9±4.5 to 15.2±2.9(P<0.05). The kyphotic Cobb angle in traction group (77.9°±26.5°) was much worse than that in no traction group (54.7°±18.2°, P<0.05) before the treatment. But the final surgical correction in traction group (81.7±17.9)% was better than that in no traction group (73.4±25.8)%. The pre-correction rate of (70.3±18.7)% and final surgical correction rate of (83.8±14.4)% in patients with suspended traction were higher than those of (52.2±21.8)% and (70.4±32.1)% with skull traction, nonetheless, the difference was not statistically significant. Conclusions: The pre-correction by cervical spine traction and final surgical correction by anterior, posterior or combined approaches of internal fixation and fusion can achieve good results for severe cervical spine kyphosis.