Closing-opening wedge osteotomy to correct angular kyphotic deformity by a single posterior approach
- VernacularTitle:一期后路闭合式-张开式联合楔形截骨术矫正角形脊柱后凸
- Author:
Kawahara NORIO
;
Gaisheng SUN
;
Huizhong TIAN
- Publication Type:Journal Article
- Keywords:
angular kyphosis;
circumspinal decompression;
correction osteotomy;
single posterior approach
- From:
Orthopedic Journal of China
2006;0(17):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To examine the safety and efficacy of closing-opening wedege osteotomy for angular kyphosis.Seven patients with angular kyphotic deformity of the thoracic or thoracolumbar spine were treated by closing-opening wedge osteotomy using a single posterior approach.[Method]Seven patients with angular kyphosis were treated.The apex level of kyphosiswas T5 in one patient,T11 in one,and T12 in five.There was old fracture in five patients,congenital deformity in one,and neurofibromatosis in one.The first 30?~35? of kyphosis were corrected using the closing wedge technique with the hinge of the anterior longitudinal ligament after veretebrectomy and circumspinal decompression of the spinal cord.Then the hinge was moved posteriorly to the spinal cord and the remainder of the requisit angle of osteotomy was corrected using the opening-wedge technique(closing-opening wedge osteotomy).Spinal curvature was stabilized using posterior instrumentation and graft.[Result]Localized kyphosis was reduced from and average of 67? to 18? at 2.2 to 7.5 years ' follow-up.Sagittal alignment from T1 to the sacrum became more physiologic than before.There were no neurologic complications.Bony fusion was achieved in all patients,and there was no correction loss.[Conclusion]Satisfactory correction is safely performed by closing-opening wedged osteotomy with a direct visuzlization of the circumferentiall decompressed spinal cord.Although the performance is technically laborious,it offers good correction without jeopardizing the integrity of the spinal cord.
