Treatment of Kyphosis

An adolescent with severe kyphosis causing pain or appearance concerns may elect to have this deformity fixed with surgery. The surgery for kyphosis is a posterior spinal fusion with instrumentation. The surgery itself takes four to five hours with a hospital stay of three to four days. The recovery is typically four to six weeks at home.

This surgery involves exposing the bones and muscles of the spine through an incision made straight down the middle of the back. The incision is only the length of the deformity needing correction. The bones of the spine are released and prepared.

Illustration showing the pedicle screw through the pedicle
Then, 2-inch screws made of titanium are placed in the pedicles. Each vertebra has a strong strut of bone on either side called a pedicle. The center of the vertebral column is hollow, forming a channel to house the spinal cord and cerebrospinal fluid. Extreme caution is taken to protect the spinal cord. Steps we take include pedicle screw placement using real-time X-ray (fluoroscopy) for guidance and continuous monitoring of the activity of the spinal cord. This is done by placing electrodes on the child from the head to the toes and measuring the signals back and forth. A specialist called a neurophysiologist is in charge of interpreting the spinal cord monitoring and alerting the surgeon of any changes.

Once all the pedicle screws are in position, the kyphosis is corrected. This is a maneuver performed by the surgeon allowing for correction of the arch in the spine. The rods, made of cobalt chrome, are then threaded through the screws and the screws are locked down. Bone graft is taken from the patient’s own rib. This is cut into small matchsticks and packed in along the back of the spine to create the spinal fusion.

Finally, the muscle layers are closed with stitches that dissolve inside the body. The outermost skin layer is closed with butterfly closures or stitch tapes. These adhesive stitches fall off on their own, after the skin has knit itself back together.