Correction of cervical kyphosis using pedicle screw fixation systems

Study Design. This retrospective study was conducted to analyze the clinical results in 30 patients with cervical kyphosis that had been treated using cervical pedicle screw fixation systems. Objectives. To evaluate the effectiveness of a pedicle screw fixation procedure in correction of cervical kyphosis. Summary of Background Data. Correction of cervical kyphosis is a challenging problem in the field of spinal surgery. There have been several reports regarding surgical correction of cervical kyphosis; however, there have been no detailed reports on correction of cervical kyphosis using a pedicle screw fixation procedure. Methods. Thirty patients with cervical kyphosis underwent correction and fusion using cervical pedicle screw fixation. Seventeen of 30 patients with flexible kyphosis (Group I) were managed by a posterior procedure alone. The remaining 13 patients with rigid or fixed kyphosis (Group Il) had a combined anterior and posterior procedure. Results. The average preoperative cervical kyphosis of 29.4 degrees improved to 2.3 degrees after surgery and was 2.8 degrees at the final follow-up. in Group I patients, preoperative kyphosis of 28.4 degrees improved to 5.1 degrees at the final follow-up. In contrast, preoperative kyphosis of 30.8 degrees in Group II patients improved to 0.5 degrees at the final follow-up. Solid fusion was achieved in all patients. There were two patients with transient nerve root complications related to pedicle screw instrumentation. Conclusions. Cervical kyphosis in 30 patients was effectively corrected using a pedicle screw fixation procedure with no serious complications. Flexible kyphosis with segmental motion can be satisfactorily corrected by a single posterior procedure using pedicle screw fixation. However, circumferential osteotomies combined with a posterior shortening procedure involving a pedicle screw system are required to achieve the best correction of fixed kyphosis by bony union. Cervical pedicle screw fixation is the most advantageous instrumentation in the correction of cervical kyphosis.