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Post traumatic kyphosis occurs most commonly in the thoracolumbar and lumbar regions. Kyphosis of this kind is most common in patients with severe neurologic deficits such as quadriplegia or paraplegia. (figure 1A)
|Figure 1A-D: Post traumatic kyphosis can occur due to the failure of the initial management of the injury or unrecognized injury. It may also result from inadequate surgical treatment as shown in the figures to the right.
Kyphosis can result in chronic disabling pain. The sources of pain include:
- spinal muscle fatigue
- chronic inflammation and progressive degeneration
- anterior cord or root impingement
Progressive kyphosis develops when there is major disruption of the anterior column and all posterior ligaments. In paraplegic patients problems with sitting balance and skin alterations may be due to excessive kyphosis.
The treatment of kyphosis is designed to correct the deformity, stabilize the area, decrease pain and improve neurologic function.
Flexible deformities can be treated with posterior fusion and instrumentation. Fixed deformities often require more complex surgery.
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