Describe the principles of surgical treatment for posttraumatic kyphosis

Posttraumatic kyphosis is most commonly a short-radius kyphotic deformity that may be either flexible or rigid. Factors to consider in the surgical treatment of posttraumatic kyphosis include the magnitude of deformity, the number of involved levels, global sagittal balance, effects of prior surgical procedures, the presence or absence of neurologic deficit, and the stability of the anterior and posterior spinal columns. Isolated anterior surgical procedures are often insufficient because the posterior osteoligamentous structures impede adequate deformity correction and restoration of normal spinal biomechanics. Decision making regarding surgical treatment must be individualized. Valid treatment options for posttraumatic kyphotic deformities include pedicle subtraction osteotomies, Smith-Petersen osteotomies, and combined anterior and posterior procedures. See Figure 53-2.

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