Abstract
Purpose: To describe the Halifax anterior-posterior kyphectomy, and report on a series consecutive patients.
Method: Twenty-two patients received a Halifax kyphectomy over a 23 year period. Patient charts were examined, and radiographs measured pre- immediately post- and at final follow up. Cobb’s method was used to determine kyphosis angle. The procedure itself involves an apical kyphectomy, and cord transection if necessary, followed by the insertion of two rods distally and anteriorly in the vertebral bodies. This is followed by sublaminar wires superiorly and reduction of the kyphosis. Data was analysed to attempt to find a correlation between age, deformity, OR time, length of stay and maintainence of correction.
Results: Mean age was 7.59 years (2–17); mean pre-op kyphosis was 123.19 degrees (79–163); post-op 40.43 degrees (13–92); mean correction of 82.29 (39–153). Mean follow-up was 6.38 years (0–14); mean kyphosis at follow-up was 60.24 degrees (14–126), mean final correction of 63.43 degrees (−37–162); mean loss of correction 19.33 degrees (−9–76). The average OR time was 247.86 minutes (180–345); EBL 765cc (140–2100) and length of stay 13.68 days (1–57). Eight patients required hardware removal, and two of these required revision surgery. The other six patients maintained correction without hardware, and did not require re-operation. One patient had a rod fracture, but did not require revision or removal. Twelve patients had no complications. There was one intra-operative mortality.
Conclusion: The Halifax kyphectomy is a safe, effective treatment for kyphosis in myelomeningocele patients. Outcomes in this series are comparable to the available literature.
Correspondence should be addressed to Meghan Corbeil, Meetings Coordinator Email: meghan@canorth.org
