Anterior strut-grafting was used in forty-eight patients to treat
structural kyphosis of the thoracic and lumbar spine. Forty patients had a
combined anterior and posterior arthrodesis. Kyphosis was corrected from an
average of 93 degrees preoperatively to an average of 59 degrees at
follow-up. Eight patients underwent anterior cord decompression, five of
whom showed improvement of neural function at follow-up. Ten patients had a
loss of correction averaging 19 degrees. In four patients a pseudarthrosis
developed at the strut graft-vertebral body junction. The strut graft
fractured in five of nine patients in whom the graft was four centimeters
or more from the apical vertebra. Complications were frequent, but for the
most part they were thought to have been preventable. Anterior
strut-grafting appears to be a valid and logical technique for managing
structural kyphosis.