Comparison of two surgeries in treatment of severe kyphotic deformity caused by ankylosing spondylitis: Transpedicular bivertebrae wedge osteotomy versus one-stage interrupted two-level transpedicular wedge osteotomy.

Abstract

OBJECTIVE:

To explore a simple and effective surgery for correcting severe kyphotic deformity caused by ankylosing spondylitis (AS).

MATERIALS AND METHODS:

From January 2003 to December 2009, we respectively reviewed 32 patients with severe spinal kyphosis caused by AS with at least 2-year follow-up. Patients were divided into two groups, according to surgical methods: transpedicular bivertebrae wedge osteotomy (Group A) or one-stage interrupted two-level transpedicular wedge osteotomy (Group B). We recorded operating time and blood loss. Variation between pre- and post-operative sagittal imbalance, global spinal alignments (Cobb angle of T1 and L5, TLKA), lumbar lordosis, chin-brow vertical angle, thoracolumbar kyphosis angle in both groups were analyzed.

RESULTS:

The average operating time was 236 ± 39 min and the average blood loss was 2200 ± 712 ml in Group A, and 252 ± 43 min, 2202 ± 737 ml respectively in Group B. There were no significant differences in operating time and blood loss. Variation between pre- and post-operative sagittal imbalance, global spinal alignments, lumbar lordosis and chin-brow vertical angle (CBVA) were comparable between the two groups. The variation of thoracolumbar kyphosis angle was significantly greater in Group B compared with Group A. SRS-22 scores were similar in the two groups at the 2-year follow-up and significantly improved compared with preoperative.

CONCLUSIONS:

For correcting severe kyphosis in patients with AS, the one-stage interrupted two-level transpedicular wedge osteotomy is a safe and effective technique which can significantly improve the thoracolumbar kyphosis angle.

• Authors: Yongfei Zhao, Hui Xu, Yonggang Zhang, Zheng Wang, Xuesong Zhang, Yan Wang
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 139 Pg. 252-7 (Dec 2015) ISSN: 1872-6968 [Electronic] Netherlands
• PMID: 26539670 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2015 Elsevier B.V. All rights reserved.

Topics

• Adult
• Blood Loss, Surgical
• Female
• Humans
• Kyphosis (etiology, surgery)
• Lordosis
• Lumbar Vertebrae (surgery)
• Male
• Middle Aged
• Operative Time
• Osteotomy (methods)
• Retrospective Studies
• Severity of Illness Index
• Spondylitis, Ankylosing (complications, surgery)
• Thoracic Vertebrae (surgery)
• Treatment Outcome