The Journal of Bone and Joint Surgery, Vol 63, Issue 6 891-899, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Post-traumatic kyphosis. A review of forty-eight surgically treated patients
BW Malcolm, DS Bradford, RB Winter and SN Chou
We reviewed the cases of forty-eight patients who were treated surgically
for symptomatic post-traumatic kyphosis of the thoracic or lumbar spine six
months or longer after the initial injury. Presenting signs and symptoms
included pain in 94 per cent, progression of kyphosis in 46 per cent,
instability in 36 per cent, and increasing neural deficit in 27 per cent.
Twenty-four patients had had a prior laminectomy. Posterior fusion (sixteen
patients) and combined anterior and posterior fusion (twenty patients)
always resulted in primary fusion. Anterior fusion alone was attempted in
twelve patients, but failed in six. The average final correction of the
deformity was 26 per cent. Pain was reduced significantly in 31 per cent of
the patients and was relieved completely in 67 per cent. Fourteen of the
forty-eight patients also had an anterior decompression, of whom five were
neurologically improved, four were unchanged or stabilized, and four were
immediately worse after operation. One patient was neurologically stable
for twenty-three months postoperatively and then deteriorated again. No
patients were neurologically improved following posterolateral
decompression or repeat exploratory laminectomy.
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