Results of kyphectomy with the technique of Warner and Fackler in children with myelodysplasia.

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 degrees 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 degrees 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.