Der Orthopäde
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Thoracic and thoracolumbar kyphosis is a common deformity in pediatric and adolescent populations. Kyphotic deformation of the spine is defined as a curve which shows an increase in the dorsal convex angulation. The most common causes of kyphosis in pediatric and adolescent populations are Scheuermann's disease, postural and congenital kyphosis. ⋯ Clinically significant sagittal deformities can lead to severe pain, substantial cosmetic alterations, spinal cord dysfunction, problems with swallowing, gastrointestinal and cardiopulmonary complications. When the kyphotic deformity exceeds a certain point and conservative therapy options are no longer sufficient surgical intervention is indicated. The available operative options for treatment of the various types of pediatric and adolescent thoracolumbar kyphosis include dorsal instrumentation and fusion combined with ventral fusion and purely ventral instrumentation and fusion.
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Review Comparative Study Controlled Clinical Trial
[Multiplan correction of a 3D deformity. Options and relevance of optimizing the thoracic kyphosis in reconstructive scoliosis surgery].
There is presently still no consensus on how to operatively treat adolescent idiopathic scoliosis (AIS), i.e. a clearly reduced thoracic kyphosis. For a long time the primary focus was mostly on correcting the coronal plane while neglecting the sagittal profile. Based on the current literature and own retrospective data a comprehensive review will be given on the optimal correction of the spine and how to avoid secondary complications. Different operative standard procedures are demonstrated with special attention to the sagittal balance and the special parameters sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sagittal slope (SSL) and pelvic incidence (PI). ⋯ Both the results from the literature and own data confirm that operative correction of AIS needs a careful planning including sagittal spinopelvic parameters. Rigid thoracic hypokyphosis require additional osteotomy.