Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
Spine Deform. 2024 May;12(3):603-620. doi: 10.1007/s43390-023-00809-4. Epub 2024 Jan 22.
Pediatric cervical kyphosis is a distinct entity with diverse etiology (congenital, syndromic, traumatic, metabolic or neoplastic). Surgical correction in pediatric population is challenging due to their growing spine and low blood volume.
To analyse their presentation, surgical techniques and outcome of pediatric cervical kyphosis and systematically review the pertinent literature.
Retrospective study.
16 patients aged ≤ 18 years who underwent correction for cervical kyphosis between 2009 and 2021.
Nurick's grading, mJOA score and Global cobb's angle.
Clinical parameters (Nurick grading and mJOA score) were noted from database on admission and on follow-up at 6 months. Radiological parameters of assessment included Global Cobb's angle. The C2-C7 Cobb angle was the angle of C2 vertebra lower end plate and C7 vertebra lower end plate. For C1-2 kyphosis, anterior border of C1 and anterior border of C2 angle was taken. Radiographic parameters were studied on CT and radiographs of cervical spine to assess for stability, the degree of deformity correction and fusion status at 6 months follow-up.
16 patients with mean age of 14.2 ± 3 years (9 syndromic, 4 post-traumatic, 2 metabolic and 1 post-laminectomy). All underwent surgical correction, 6 underwent Antero-posterior spinal fusion, 6 underwent Posterior spinal fusion and 4 underwent Anterior spinal fusion. There was significant clinical improvement postoperatively with-Nurick grade (pre vs. post: 2.8 vs. 1.8, p = 0.004), mJOA score (pre vs. post: 11.3 vs. 14, p = 0.003). There was significant deformity correction of Cobb's angle from 40.7 ± 26.5° to 14.9 ± 10° (p = 0.001). Early complications included intraoperative hemodynamic instability (3) and wound complication (1). Mean follow-up was 76.9 ± 59.3 months.
Pediatric cervical kyphosis is a debilitating condition which are managed surgically. Approach has to be individualized to the pathology and good results can be achieved. Patients should be screened for syndromic association and followed-up regularly.
小儿颈椎后凸是一种具有多种病因（先天性、综合征、创伤性、代谢性或肿瘤性）的独特实体。由于儿童的脊柱在不断生长且血容量较低，因此对其进行手术矫正具有挑战性。
分析小儿颈椎后凸的表现、手术技术和结果，并系统回顾相关文献。
回顾性研究。
2009 年至 2021 年间接受颈椎后凸矫正手术的 16 名年龄≤18 岁的患者。
Nurick 分级、mJOA 评分和全局 Cobb 角。
从数据库中记录入院时和 6 个月随访时的临床参数（Nurick 分级和 mJOA 评分）。评估的放射学参数包括全局 Cobb 角。C2-C7 Cobb 角为 C2 椎体下缘和 C7 椎体下缘的角度。对于 C1-2 后凸，取 C1 前缘和 C2 前缘角度。在颈椎 CT 和 X 线片上研究放射学参数，以评估 6 个月随访时的稳定性、畸形矫正程度和融合状态。
16 例患者的平均年龄为 14.2±3 岁（9 例综合征、4 例创伤后、2 例代谢性和 1 例椎板切除术后）。所有患者均接受手术矫正，其中 6 例行前后路脊柱融合术，6 例行后路脊柱融合术，4 例行前路脊柱融合术。术后临床改善显著，Nurick 分级（术前 vs. 术后：2.8 比 1.8，p=0.004），mJOA 评分（术前 vs. 术后：11.3 比 14，p=0.003）。Cobb 角的畸形矫正显著，从 40.7±26.5°变为 14.9±10°（p=0.001）。早期并发症包括术中血流动力学不稳定（3 例）和伤口并发症（1 例）。平均随访时间为 76.9±59.3 个月。
小儿颈椎后凸是一种使人虚弱的疾病，需要手术治疗。治疗方法必须根据病变个体化，才能取得良好的效果。应筛查患者的综合征相关性，并定期随访。
