Evaluation of preoperative prediction methods for osteotomy angle of ankylosing spondylitis thora-columbar kyphosis
10.3969/j.issn.1004-406X.2024.09.04
- VernacularTitle:强直性脊柱炎胸腰椎后凸畸形截骨角度术前预测方法的评价
- Author:
Shuwen ZHANG
1
;
Hao WANG
;
Weibin SHENG
Author Information
1. 新疆维吾尔自治区人民医院脊柱外科 830000乌鲁木齐市
- Keywords:
Ankylosing spondylitis;
Kyphosis;
Osteotomy angle prediction
- From:
Chinese Journal of Spine and Spinal Cord
2024;34(9):921-929
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the preoperative prediction methods of osteotomy angle of thoracolumbar kyphosis in ankylosing spondylitis(AS)patients,and to analyze their clinical values in reconstruction of spinopelvic sagittal alignment.Methods:22 AS patients with thoracolumbar kyphosis,who underwent single segment pedicle subtraction osteotomy(PSO)from January 2015 to January 2022 in the First Affiliated Hospital of Xinjiang Medical University,were retrospectively reviewed.There were 17 males and 5 females with a mean age of 44.3±7.4 years(range,29-56 years).Preoperative and postoperative spinopelvic parameters were measured on X-ray lateral radiographs,osteotomy angles were predicted with different methods,full balance integated index(FBI),spine femoral angle(SFA),hilus pulmonis-hip axis(HP-HA),center of both acoustic meati-hip axis(CAM-HA),and Surgimap method.And theoretical spinopelvic parameters and theoretical os-teotomy angle were calculated according to pelvic incidence(PI).The differences between preoperative,final follow-up and theoretical spinopelvic parameters,and between the predictive,actual and theoretical osteotomy angles,were compared.Results:The osteotomy sites of the 22 cases included 4 in L1,10 in L2 and 8 in L3.All the patients achieved ideal imaging and surgical results.The differences in pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),thoracic kyphosis(TK),thoracolumbar kyphosis(TLK),global kyphosis(GK),and sagittal vertical axis(SVA)between final follow-up and preoperation were statistically significant(P＜0.05).The osteotomy angles predicted with FBI,SFA,HP-HA,CAM-HA,and Surgimap methods were 50.5°±12.1°,52.0°±11.3°,53.9°±8.1°,51.3°±5.8°,and 43.2°±9.2°,respectively,with statistically significant differences(F=2.342,P=0.046).The theoretical osteotomy angle required by simulated osteotomy to restore the ideal spinopelvic sagittal alignment was 51.2°±8.1°,which wasn't statistically different from the osteotomy angles predicted with FBI,SFA,HP-HA or CAM-HA methods(P＞0.05).The actual osteotomy angle during the operation was 41.1°±5.4°,which was statistically different from the osteotomy angles predicted with FBI,SFA,HP-HA and CAM-HA methods(P＜0.05),but not statistically different with the angle predicted with Surgimap method(P＞0.05).Conclusions:The osteotomy angles predicted with FBI,SFA,HP-HA,and CAM-HA methods are similar with the theoretical osteotomy angle,while different from the actual osteotomy angle to some extent;The osteotomy angle predicted with Surgimap method is similar with the actual osteotomy angle.
