Approach to Congenital Kyphosis
As in all congenital spine abnormalities, there is a high incidence of associated anomalies within and outside the spine
– spinal dysraphism (in 40%!!), diastematomyelia, tethered cord, syrinx, Arnold-Chiari malformation, diplomyelia, intraspinal tumour
– look for hairy patches, cutaneous nevi, dimples or clefts, and neurologic signs
– look for genitourinary abnormalities and cardiac abnormalities
– congenital kyphosis is more common than lordosis, but much less common than congenital scoliosis
– the treatment of congenital kyphosis is SURGERY – there is NO ROLE for conservative management (braces)
Failure of Segmentation
– produces a rounded gibbus and is fairly benign; most of the problems occur from the compensatory lumbar lordosis. – paraplegia is rarely a problem.
– posterior fusion will halt progression and leave the present deformity
– anterior and posterior fusion is necessary to correct the deformity
Failure of Formation
– produces a sharp kyphosis and is the leading cause of paraplegia due to spinal deformity.
– usually requires anterior/posterior approach.