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Cervical kyphosis correction

Cervical kyphosis correction is a surgery designed to restore neck balance when the spine loses its natural curve and tilts forward. Many patients reach our clinic with a neck that cannot hold itself up, persistent pain, difficulty looking ahead or neurological symptoms from spinal cord compression after previous surgery, ankylosing spondylitis or advanced degeneration. At our practice in Alicante and Benidorm we assess every case with dynamic imaging, 3D planning and an individualised surgical plan to realign the neck as safely as possible.

Spine neurosurgeon in Alicante and Benidorm
More than 20 years of experience in Neurosurgery (since 2003)
Vithas Medimar Hospital Alicante and Hospital Clínica Benidorm
Cervical kyphosis correction illustration showing posterior osteotomies and instrumentation with lateral mass and pedicle screws to realign the neck.

What is cervical kyphosis correction?

Cervical kyphosis correction is a surgery aimed at restoring the natural curve of the neck when it has been lost and the spine tilts forward. Depending on the stiffness and the size of the deformity, we combine decompression, osteotomies and instrumentation with screws and rods to restore sagittal balance across the C2-C7 segment.

Flexible kyphosis can sometimes be addressed with posterior cervical fusion or a multilevel ACDF. Fixed kyphosis, usually linked to ankylosing spondylitis or extensive previous laminectomies, often requires a combined anterior-posterior approach with Smith-Petersen or pedicle subtraction osteotomies. To discuss your case, you can request an assessment with Dr. Ben Ghezala.

Symptoms and warning signs

Patients with symptomatic cervical kyphosis usually describe:

Forward-tilted neck and difficulty looking straight ahead (horizontal gaze loss)
Sensation of a heavy head or that the neck cannot hold the head up
Persistent neck pain, muscle spasm and pain at the cervicothoracic junction
Neurological symptoms: weakness, clumsy hands, gait disturbance or bowel and bladder changes
History of cervical laminectomy, ankylosing spondylitis, trauma or previous surgery that did not heal properly
Warning signs: rapid loss of strength, falls or changes in bladder or bowel control

When is this surgery indicated?

Symptomatic cervical kyphosis with loss of lordosis and sagittal imbalance (raised C2-C7 axis or altered chin-brow vertical angle)
Cervical myelopathy associated with the deformity, with progressive neurological signs
Post-laminectomy kyphosis or deformity after previous cervical surgery that did not consolidate
Fixed kyphosis due to ankylosing spondylitis or other rheumatic disease
Disabling pain and functional limitation despite adequate conservative care
Loss of horizontal gaze affecting daily life, driving or work

How is the procedure performed?

1.Preoperative preparation

Before surgery we complete a full work-up: MRI, CT with 3D reconstruction, dynamic flexion-extension X-rays and a full-spine standing radiograph to measure sagittal balance. We assess how rigid the deformity is, plan the levels to instrument and review your medication, fasting and preoperative tests.

2.During the procedure

Surgery is performed under general anaesthesia with continuous neurophysiological monitoring (motor and sensory evoked potentials). For flexible kyphosis we typically use an anterior approach with multilevel discectomies, interbody cages and a plate. For rigid kyphosis we combine an anterior release with a posterior stage involving osteotomies (Smith-Petersen or pedicle subtraction) and instrumentation with lateral mass and pedicle screws. Realignment is done in a controlled fashion to protect the spinal cord and nerve roots.

3.Immediate postoperative period

After surgery you will spend a few hours in recovery with close neurological monitoring. Once stable you return to the ward. Gentle mobilisation with a collar starts on day one and pain is managed with a multimodal protocol. Hospital stay is usually 3 to 7 days depending on the complexity of the correction.

Recovery after cervical kyphosis correction

Recovery after a cervical correction is longer than after a simple cervical surgery because osteotomies and multilevel instrumentation are involved. The first 2-3 weeks focus on wound care, walking and postural hygiene, with a collar when indicated.

At 4-6 weeks most patients resume daily activities and driving when we authorise it. Office work usually restarts between 6 and 12 weeks, whereas physical jobs need 3 to 6 months. Fusion consolidates over several months, so we avoid heavy strain early on and plan rehabilitation for the neck and posterior muscles.

Fever, wound discharge, new severe pain or any neurological change should be reviewed immediately.

Risks and possible complications

Every surgery carries general risks such as infection, bleeding, thrombosis or anaesthetic complications. Cervical kyphosis correction is major surgery and the specific risks deserve an honest explanation.

The most relevant ones are injury to the spinal cord or nerve roots during realignment, hardware loosening or failure, pseudarthrosis (non-union), transient or prolonged dysphagia, vascular injury, proximal or distal junctional kyphosis and the need for revision surgery. This is why we use continuous neurophysiological monitoring and 3D planning, and why we reserve this surgery for carefully selected cases.

Frequently asked questions

It depends on the type of kyphosis and the approach. An anterior correction of a flexible kyphosis usually lasts between 3 and 5 hours. A correction of fixed kyphosis with a combined approach and osteotomies can last 6 to 10 hours, in one or two surgical sessions.
In most cases yes, for several weeks. The type of collar and the duration depend on the levels instrumented and on bone quality. We explain the exact rules at discharge and adjust them at follow-up.
The main goal of the surgery is to restore horizontal gaze and an acceptable sagittal balance. The degree of improvement depends on how rigid the deformity is, the level of the kyphotic apex and the condition of the adjacent segments.
Driving and office work usually resume between 6 and 12 weeks. Physical jobs or roles that require a lot of neck movement need 3 to 6 months. Every plan is adjusted in the clinic based on recovery and imaging.
Post-laminectomy kyphosis is a frequent indication. We study how flexible the deformity is and the neurological status to decide whether a posterior reinforcement is enough, whether a multilevel anterior approach is preferable or whether a combined correction with osteotomies is needed.
We perform this surgery at Hospital Clinica Benidorm (HCB) and at Hospital Vithas Medimar in Alicante. We choose the centre based on case complexity, availability of neurophysiological monitoring and the patient's insurance coverage.

Other related treatments

Anatomical illustration of anterior cervical fusion with interbody cage and screw-fixed plate.

Anterior cervical fusion (interbody fusion with plate)

Anterior cervical surgery to decompress nerves and stabilise a severely degenerated or herniated disc when pain and symptoms persist despite medication, physiotherapy or injections.

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Posterior cervical fusion illustration with lateral mass screws and longitudinal rods.

Posterior cervical fusion (instrumentation with lateral mass or cervical pedicle screws)

Posterior cervical surgery with screws and rods to decompress and stabilise the spine in patients with pain, instability or cord compression not improved by conservative care.

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Cervical disc arthroplasty illustration showing motion-preserving disc prosthesis.

Cervical disc arthroplasty (cervical disc prosthesis)

Surgery that replaces a damaged cervical disc with a mobile prosthesis to relieve nerve compression and preserve motion when conservative care is no longer enough.

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Do these symptoms sound familiar?

If you recognise yourself in some of these symptoms and your pain is starting to limit your daily life, we can review your case in a personalised consultation. Dr. Ben Ghezala will assess your clinical history and imaging studies to help you decide the best treatment option for you.

Request a consultation with Dr. Ben Ghezala