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[Clinical outcomes of surgical correction for ankylosing spondylitic kyphosis].

AbstractOBJECTIVE:
To evaluate the clinical outcomes of posterior surgical corrective methods for ankylosing spondylitic kyphosis.
METHODS:
From June 2003 to June 2008, 21 cases of ankylosing spondylitic kyphosis received posterior surgical correction. There were 17 male and 4 female, and the average age was 39.5 years (range, 20 to 57 years). The total spine X-ray and CT were used to evaluate sagittal balance and thoracolumbar spine kyphosis angle, and chin brow-vertical angle was obtained from clinical lateral photograph. The surgical goal was to correct sagittal imbalance and chin brow-vertical angle. The simulated osteotomy was performed in computer before surgery to determine the correction methods. The surgical methods included: 16 cases of monosegmental closing osteotomy correction, 3 cases of anterior opening-posterior closing osteotomy correction, and 2 cases of combined pedicle subtraction osteotomy in thoracolumbar spine and Smith-Peterson osteotomy in lumbar spine. All patients were followed up after surgery, and the improvement of sagittal imbalance, chin brow-vertical angle and thoracolumbar spine kyphosis angle were assessed. The symptoms relief and satisfied rate were also evaluated.
RESULTS:
The average operation time was 4.4 hours, and the average blood loss was 1770 ml. Before surgery, the average thoracolumbar kyphosis angle was 62.1°, the average anterior shift of C(7) plumb line was 172.9 mm, and the average chin brow-vertical angle was 34.9°. The average follow-up was 28.8 months after surgery. The average correction rate of thoracolumbar kyphosis angle was 60%, the average improvement rate of anterior shift of C(7) plumb line was 64%, and the average correction rate of chin brow-vertical angle was 98%. The improvement rate of back pain was 64% during follow-up. The total surgical satisfactory rate was 95%.
CONCLUSION:
Based on the simulated osteotomy in computer before surgery, according to the characteristics of ankylosing spondylitic kyphosis, different posterior osteotomy and correction methods can achieve good results.
AuthorsYan Zeng, Zhong-qiang Chen, Zhao-qing Guo, Qiang Qi, Chui-guo Sun, Wei-shi Li
JournalZhonghua wai ke za zhi [Chinese journal of surgery] (Zhonghua Wai Ke Za Zhi) Vol. 48 Issue 16 Pg. 1234-7 (Aug 15 2010) ISSN: 0529-5815 [Print] China
PMID21055213 (Publication Type: English Abstract, Journal Article)
Topics
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Kyphosis (etiology, surgery)
  • Male
  • Middle Aged
  • Osteotomy (methods)
  • Spondylitis, Ankylosing (complications)
  • Treatment Outcome
  • Young Adult

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