{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:50:40Z","timestamp":1780717840856,"version":"3.54.1"},"reference-count":18,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"11","license":[{"start":{"date-parts":[[2013,11,1]],"date-time":"2013-11-01T00:00:00Z","timestamp":1383264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:p> A combined anterior and posterior surgical approach is generally recommended in the treatment of severe congenital kyphosis, despite the fact that the anterior vascular supply of the spine and viscera are at risk during exposure. The aim of this study was to determine whether the surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach is feasible, safe and effective. <\/jats:p><jats:p> We reviewed the records of ten patients with a mean age of 11.1 years (5.4 to 14.1) who underwent surgery either by pedicle subtraction osteotomy or by vertebral column resection with instrumented fusion through a single posterior approach. <\/jats:p><jats:p> The mean kyphotic deformity improved from 59.9\u00b0 (45\u00b0 to 110\u00b0) pre-operatively to 17.5\u00b0 (3\u00b0 to 40\u00b0) at a mean follow-up of 47.0 months (29 to 85). Spinal cord monitoring was used in all patients and there were no complications during surgery. These promising results indicate the possible advantages of the described technique over the established procedures. We believe that surgery should be performed in case of documented progression and before structural secondary curves develop. Our current strategy after documented progression is to recommend surgery at the age of five years and when 90% of the diameter of the spinal canal has already developed. <\/jats:p><jats:p> Cite this article: Bone Joint J 2013;95-B:1527\u201332. <\/jats:p>","DOI":"10.1302\/0301-620x.95b11.31376","type":"journal-article","created":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T11:27:58Z","timestamp":1382441278000},"page":"1527-1532","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach"],"prefix":"10.1302","volume":"95-B","author":[{"given":"A. S.","family":"Spiro","sequence":"first","affiliation":[{"name":"University Medical Center Hamburg\u2013Eppendorf, Department\rof Trauma, Hand and Reconstructive Surgery, Martinistrasse\r52, 20246 Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rupprecht","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Hamburg\u2013Altona, Department\rof Pediatric Orthopaedic Surgery, Bleickenallee\r38, 22763 Hamburg and Department of Orthopaedics,\rUniversity Medical Centre Hamburg-Eppendorf, Martinistrasse\r52, 20246, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Stenger","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Hamburg\u2013Altona, Department\rof Pediatric Orthopaedic Surgery, Bleickenallee\r38, 22763 Hamburg and Department of Orthopaedics,\rUniversity Medical Centre Hamburg-Eppendorf, Martinistrasse\r52, 20246, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg\u2013Eppendorf, Department\rof Trauma, Hand and Reconstructive Surgery, Martinistrasse\r52, 20246 Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kunkel","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Hamburg\u2013Altona, Department\rof Pediatric Neurosurgery, Bleickenallee 38, 22763\rHamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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