Pathological lumbar kyphosis occurs in approximately 8% to 20% of patients with myelomeningocele. During the past 4 years, nine patients with an average preoperative kyphosis of 152° were surgically corrected. They had a short fusion and a long stabilization with Luque rod instrumentation using a technique described by Warner and Fackler (1993). The average degree of correction was 104° and, on average, 2.5 vertebrae were resected. The average surgical time was 225 minutes, and blood loss averaged 635 ml. We saw two complications: one penetration of the distal part of the rod through the sacrum after 32 months, and a dislocation of the rods out of the first sacral foramen after 33 months. From our experience, this procedure is highly demanding, but effective. It should be limited to patients below the weight of 30 kg.
Address correspondence and reprint requests to Dr Marc Thomsen, Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstraβe 200a, D-69118 Heidelberg, Germany.
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