Posterior surgery assisted by halo ring traction for the treatment of severe rigid nonangular cervical kyphosis.

Abstract

The correction of cervical kyphosis is a challenging problem in spinal surgery. Several reports exist regarding the surgical correction of severe rigid cervical kyphosis; however, no detailed reports exist on the correction of severe rigid nonangular cervical kyphosis. The goal of this study was to analyze the clinical and radiographic outcomes of surgical treatment for severe rigid nonangular cervical kyphosis.Thirteen patients with severe rigid nonangular cervical kyphosis who were treated with primary halo ring cervical traction for 7 to 16 days (average, 10 days) were studied. When the preoperative kyphosis was corrected by at least 30%, they underwent fusion and correction using internal screw-rod fixation via a posterior approach. All patients were followed up for 25 to 62 months (average, 46 months). The results were studied clinically and radiographically. The average cervical kyphosis was 45.3 degrees on admission and was corrected to -0.8 degrees postoperatively and was -0.4 degrees at final follow-up. There was a mean improvement of 4.7 in the Japanese Orthopedic Association (JOA) scores, from a mean score of 10.7 on admission to 15.4 at final follow-up. Nerve function improved 74.6% on average. All patients underwent solid bony fusion within 6 months postoperatively. A transient C5 nerve paresis was noted in 2 patients.Primary halo ring traction with posterior correction using subsequent internal screw-rod fixation proved to be safe and effective for treating severe rigid nonangular cervical kyphosis. This treatment can achieve the goals of complete spinal cord decompression and deformity correction.