After Congenital Rachis Convex Postoperative 2 Years Follow-up Results

Objective To evaluate the long-term outcomes and complications of operation in the treatment of congenital kyphosis.Methods From August2008to May2012,21congenital kyphosis cases(9males,12females)who were treated by operation with an average age of15.4years at surgery(range,2-42years) were investigated retrospectively. I type,8cases; II type,8cases; Ⅲ type,6cases。Associated congenital anomalies were involved in6cases, including5cases with spine anomalies. Operating time,intraoperative blood loss and peri operative complications were recorded by reviewing the medical records.By measuring the standing lateral before and after surgery,and at the last follow-up,the sagittal Cobb angle, Sagittal balance were recorded。 Also,the status of spinal fusion and the failure of implants were observed and evaluated.Results The mean operation time was310min(range,150-400min). The mean blood loss was1020ml(range,200-2800ml). The mean follow-up period was48months(range,27-108months). The mean fusion level was5.4(range,3-8). The regional kyphosis of14patients who were treated by VCR,including hemivertebra excision, was corrected from70.4°to16.9°with a correction rate of76%. No obvious loss of correction was noted at the final follow-up. The sagittal balance was improved from-30.4mm preoperatively to-39.2mm postoperatively and-20.2mm at final follow—up. The regional kyphosis of five patients who were treated by PSO was corrected from44°to17.8°with a correction rate of59.5%. No obvious loss of correction was noted at the final follow-up. The sagittal balance was improved from-30.4mm preoperatively to-22mm postoperatively and-11mm at final follow—up. The regional kyphosis of two patients who were treated by SPO was corrected from50°to39.5°with a correction rate of21%. No obvious loss of correction was noted at the final follow-up. The sagittal balance was improved from-58.5mm preoperatively to-48mm postoperatively and-40mm at final follow—up. Complications included muscle weakness of two lower limb after surgery but recovered in two cases.Conclusions Congenital kyphosis was early onset and progressed rapidly. The effectivness of conservative treatments was not satisfied. It would be generally controlled by early operations. We can achieve satisfying results by operating hemivertebra excision and VCR.It would be very important to prevent neurological and fixation complications.