The Study: Relationship between degree of focal kyphosis correction and neurological outcomes for patients undergoing cervical deformity correction surgery.
The Facts:
a. Cervical kyphosis “can lead to mechanical pain, neurological dysfunction, and functional disabilities.”
b. Therefore the more you move the kyphosis toward lordosis the more improvement there might be in outcomes.
c. The authors looked at 36 patients who suffered from myelopathic symptoms.
d. These patients had kyphotic cervical spines and underwent surgery in an attempt to improve (bring the kyphosis toward lordosis) this condition.
e. The authors looked at pre and post surgical radiographs to determine magnitude of kyphosis and the amount of improvement.
f. They compared the x-ray findings to the amount of improvement in functional outcomes.
g. “The minimum follow up time was 2 years.”
h. They found that “better outcomes were reported in patients who achieved lordosis than in those who maintained kyphosis.”
Take Home:
Kyphosis affects patients in a negative manner and in this study, returning the patient to lordosis was generally better than leaving them in kyphosis even though the method of treatment was surgery.
Reviewer’s Comments:
A sizeable portion of our profession no longer thinks spinal alignment is important. This study may give some pause to those people.
Reviewer: Roger Coleman DC
Editor’s Comments:
Everything that’s old is new, and everything that’s new is old.
Ironic isn’t it? Our profession started out as structure based (i.e. spinal alignment affects spinal function) but has spent the past 40 years moving toward a function/motion based paradigm for chiropractic. Now that structural correction is considered a hopelessly antiquated concept among most in our academic communities and the vast majority of chiropractors practice with little/no consideration toward actually correcting the patient’s posture, the medical profession is documenting the importance of restoring healthy posture for better patient outcomes. Seems like we may have thrown the baby out with the bathwater.
Editor: Mark R. Payne DC
Reference: Grosso MJ, Hwang R, Mroz T, Benzel E, Steinmetz MP. Relationship between degree of focal kyphosis correction and neurological outcomes for patients undergoing cervical deformity correction surgery. J Neurosurg Spine. 2013;18:537-44..
PubMed Reference: http://www.ncbi.nlm.nih.gov/pubmed/23560711