Document Detail


Hyperrotatory paradoxic kyphosis.
MedLine Citation:
PMID:  11840106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A retrospective radiographic evaluation of 32 patients with hyperrotatory scoliosis accompanied by paradoxic hyperkyphosis, who were treated with posterior multilevel hook instrumentation. OBJECTIVES: To give a three-dimensional analysis of this particular deformity and to evaluate the coronal, sagittal, and horizontal plane corrections in these specific curves. SUMMARY OF BACKGROUND DATA: Lordoscoliosis with a severe rotational component produces paradoxic kyphosis in the sagittal plane. A vertebral derotational maneuver is essential to restore the normal sagittal alignment. METHODS: Thirty-two patients were treated with posterior multilevel hook instrumentation. Nine patients had previously undergone anterior release and fusion. The derotational maneuver could be accomplished in 21 cases. The coronal Cobb angle and the extents of apical vertebral rotation, sagittal hyperkyphosis, upper and lower compensatory lordosis, and sagittal trunk balance were measured after an average follow-up period of 5 years and 9 months. RESULTS: The mean coronal deformity decreased from 89.9 degrees before surgery to 40.7 degrees. The mean preoperative hyperkyphosis was 70.9 degrees in the thoracic spine, 45.9 degrees in the thoracolumbar spine, and 55 degrees in the lumbar region. These values were reduced to 39.7 degrees, 6.8 degrees, and -15 degrees, respectively. The lateral spinal balance changed from -21.3 mm to -8.5 mm. The average rotational correction measured by the method of Jackson was 51% before surgery and 39% after surgery (correction: 23.5%). There was a positive correlation between the preoperative kyphosis angle and the apical rotation (r = 0.58) and between the decrease of kyphosis and the correction of the rotation (r = 0.67) in cases when the derotational maneuver could be accomplished. CONCLUSIONS: If the apex of the scoliosis and the kyphosis are on the same level, the vertebral hyperrotation is responsible for the sagittal malalignment. Satisfactory results can be achieved with posterior multilevel hook instrumentation.
Authors:
Tamás de Jonge; Jean F Dubousset; Tamás Illés
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  27     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-12     Completed Date:  2002-04-22     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-8     Citation Subset:  IM    
Affiliation:
Saint Vincent de Paul Hospital, Department of Pediatric Orthopedic Surgery, Paris, France. dejonge@clinics.pote.hu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Diskectomy / adverse effects
Female
Follow-Up Studies
Humans
Kyphosis / classification*,  complications,  diagnosis*,  surgery
Male
Postoperative Complications / etiology
Retrospective Studies
Spinal Fusion / adverse effects
Spine / abnormalities*,  surgery
Surgical Wound Infection / etiology
Torsion Abnormality / complications,  diagnosis*,  surgery
Traction
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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