Guevara VF, de la Cruz ÁS, Muñiz LL

Language: Spanish
References: 10
Page: 23-29
PDF size: 313.44 Kb.

ABSTRACT

Objective: To report de development of proximal joint kyphosis PJK in patients with congenital scoliosis with hemivertebrae that received surgical treatment with posterior arthrodesis and its relation with probable risk factors. Proximal joint kyphosis is a complication in deformity correction surgery in adults and infants, with different grades of severity. Material and methods: 13 patients with congenital scoliosis with hemivertebrae treated with posterior arthrodesis were analyzed. The correction was achieved with pedicular screws with posterior-only approach. The variables were analyzed, and so, their relation with the progression to proximal joint kyphosis. The statistical analysis was made with the Spearmen test to determine variables correlation. Results: 5 out of 13 patients developed proximal joint kyphosis, of which 1 presented pull-out of the instrumentation and another required revision surgery with extension of the operated levels. The other 3 patients progressed asymptomatic and autolimited. Sagital balance and the length of instrumentation were correlated to development of proximal joint kyphosis (r › 0.4), and strong correlation was found with superior mobile segment close to the thoracolumbar junction (r = 0.62). Conclusion: Proximal joint kyphosis is a frequent phenomenon in young patients with congenital scoliosis, which can lead to considerable complications. Sagital balance, short instrumentations and rigid segment close to thoracolumbar junction were factors related to development of this phenomenon.

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