Kyphosis Correction Surgery

Kyphosis Correction Surgery

Kyphosis is a medical term that is used to describe an exaggerated curvature of the spine. This curve is located in the mid and upper portion (thoracic region) of the back and curves outward more than usual causing what is sometimes called a “hunch back”. Mild forms of kyphosis may produce no visible physical signs or symptoms but can cause back pain and stiffness. This condition can occur at any age but is most commonly diagnosed in older women with a history of osteoporosis or vertebral compression fractures.

About

Kyphosis treatment depends on the cause and severity of the curve and surgery may be recommended for severe kyphosis. This is particularly true in patients that are experiencing compression of the spinal cord or pinched nerve roots.

Spinal fusion is the most common kyphosis correction surgery performed and is designed to reduce the degree of curvature. During this procedure, the surgeon inserts pieces of bone graft material between the vertebrae and then fastens the vertebrae together with metal rods and screws.

The goal of kyphosis correction surgery is to decrease the patient’s pain and to return the spine to a more natural position. It is not necessary with this type of surgery to completely correct the exaggerated curve but to realign the back and prevent further curvature.

This surgery can be accomplished by using minimally invasive surgical techniques which allows surgeons to precisely locate the affected area under x-ray guided fluoroscopy and repair the affected area(s) using tiny instruments that are fed through a tube. This type of procedure is call endoscopy.
Endoscopic minimally invasive procedures require a much smaller incision(s), and there is no need to cut muscle or surrounding tissues to access the surgical area. Once the incision is made, a small tube is placed into the incision. Through this tube, the surgeon can insert a small camera to visualize the area and the instruments necessary to perform the surgery.

Corrective surgery is usually recommended when thoracic curves are larger than 80° or 90° when measured on x-rays. Kyphosis can also extend into the mid or lower back. In these cases, surgery is recommended for curves larger than 60° to 70° of kyphosis. Surgery is also an option for patients with disabling back pain or when kyphosis leads to compression of the spinal cord or nerves.

Purpose

Kyphosis correction surgery is done so that the affected area of the spine heals together (a single, solid bone) in a corrected position to restore stability to the spine and limit movement of the vertebrae in this area. This procedure also helps to prevent further curvature of this area of the spine.

Benefits

The benefits of endoscopic kyphosis corrective surgery are that most endoscopic spine surgeries can be done as an outpatient and take less time to perform, it causes less tissue and muscle trauma, the risk of blood loss is reduced, there is less damage to the epidural blood supply and consequent epidural fibrosis and scarring, a reduced hospital stay, a quicker recovery, a reduced need for pain medication, and improvement in the quality of life.

Risks

While an endoscopic kyphosis correction surgery carries fewer risks than a traditional open surgical procedure, there are still some potential complications that can occur. As with any surgery that requires general anesthesia, lung problems, allergic reactions, and other drug-related complications are possible.

There is also the risk of infection at the incision site, and potential for bleeding As with any back surgery, the spinal cord, nerves, and blood vessels can be injured. The most significant risk, however, comes from having a microdiscectomy done by a surgeon who is not skilled in minimally invasive procedures. These surgeries require a specific set of skills that surgeons must be trained in.

Symptoms it Solves

A kyphosis correction surgery through endoscopic spinal fusion relieves back pain caused by the pressure put on the spinal cord and spinal nerves.

Alternatives

Some patients may try more conservative treatments to relieve back pain first, but if a weakened or damaged vertebra is putting pressure on the spinal cord or spinal nerves, then surgery will most likely be recommended.

Payments/Cost

The exact cost of this surgery depends on many factors. However, insurance typically covers all or part of this procedure, including both Medicare and Medicaid. Some patient may have co-pays or deductibles.

https://www.sciencedirect.com/science/article/pii/S1040738317301077
https://journals.lww.com/spinejournal/FullText/2018/04011/Surgical_Strategy_for_Managing_Kyphotic_Deformity.10.aspx
https://www.ncbi.nlm.nih.gov/pubmed/28760038
https://www.ncbi.nlm.nih.gov/pubmed/28881110
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821913/