Post Traumatic Kyphosis

Cause

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
Figure 1B

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.


Figure 2A
Figure 2B

Symptoms

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

Physical Findings

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.

Treatment Options

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.

References

  1. Atici T, A. U., Akesen B, Serifoglu R. (2004). "Results of surgical treatment for kyphotic deformity of the spine secondary to trauma or Scheuermann's disease." Acta Orthop Belg 70(4): 344-8.
  2. Been HD, P. R., Ubags LH. (2004). "Clinical outcome and radiographic results after surgical treatment of post-traumatic thoracolumbar kyphosis following simple type A fractures." Eur Spine J 13(2): 101-7.
  3. Jodoin A, G. P., Dupuis PR, Maurais G. (1989). "Surgical treatment of post-traumatic kyphosis: a report of 16 cases." Can J Surg. 32(1): 36-42.
  4. Klockner C, H. A., Weber U. (2001). "Post-traumatic kyphosis of the truncal vertebrae." Orthopade. 30(12): 947-54.
  5. Kostuik JP, M. H. (1989). "Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis." Spine. 14(4): 379-86.
  6. Lazennec JY, N. N., Rousseau MA, Boyer P, Pascal-Mousselard H, Saillant G. (2006). "Wedge osteotomy for treating post-traumatic kyphosis at thoracolumbar and lumbar levels." J Spinal Disord Tech. 19((7):): 487-94.
  7. Vaccaro AR, S. J. (2001). "Post-traumatic spinal deformity." 26 24(S111-8).
  8. Wawro W, B. N., Aebi M. (1992). "Technique of surgical correction of post-traumatic kyphosis." Unfallchirurg 95(1): 41-6.
  9. Wenger M, B. M., Markwalder TM. (2005). "Post-traumatic cervical kyphosis with surgical correction complicated by temporary anterior spinal artery syndrome." J Clin Neurosci 12(2): 193-6.
  10. Wu SS, H. S., Lin LC, Pai WM, Chen PQ, Au MK. (1996). "Management of rigid post-traumatic kyphosis." Spine. 21(19): 2260-7
  11. Zhi., Z. W. K. Z. (2005). "Surgical correction of post-traumatic kyphosis of thoracolumbar spine." 43(4): 201-4.
The Scoliosis Research Society provides information on these web pages regarding research and links as a public service. The SRS believes that patients should contact their treating physician about the relevance of any information listed on the site prior to proceeding with any particular treatment. Just as no two individuals are exactly alike, no two patients with a spinal deformity are the same. Therefore, your spinal deformity surgeon will be the most important source of information about the management of your particular spinal problem.