• Hiroyuki Yoshihara, Kuniyoshi Abumi, Manabu Ito, Yoshihisa Kotani, Hideki Sudo, and Masahiko Takahata.
• Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Electronic address: hiroyoshihara55@yahoo.co.jp.
• World Neurosurg. 2013 Nov 1;80(5):654.e17-21.

BackgroundSurgical treatment for severe circumferentially fixed cervical kyphosis has been challenging. Both anterior and posterior releases are necessary to provide the cervical mobility necessary for fusion in a corrected position.ObjectiveIn two case reports, we describe the circumferential osteotomy of anterior-posterior-anterior surgical sequence, and the efficacy of this technique when cervical pedicle screw fixation for severe fixed cervical kyphosis is used.Case DescriptionEtiology of fixed cervical kyphosis was unknown in one patient and neurofibromatosis in one patient. Both patients had severe fixed cervical kyphosis as determined by cervical radiographs and underwent circumferential osteotomy and fixation via an anterior-posterior-anterior surgical sequence and correction of kyphosis by pedicle screw fixation.ConclusionSevere fixed cervical kyphosis was treated successfully by the use of circumferential osteotomy and pedicle screw fixation. The surgical sequence described in this report is a reasonable approach for severe circumferentially fixed cervical kyphosis and short segment fixation can be achieved using pedicle screws.Copyright © 2013 Elsevier Inc. All rights reserved.

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