Middle-column preserved pedicle subtraction closing-opening wedge osteotomy for the treatment of stiff kyphosis
10.3760/cma.j.cn121113-20191204-00486
- VernacularTitle:保留中柱经椎弓根开合式截骨术治疗老年僵硬性脊柱后凸畸形
- Author:
Bo DENG
;
Yao CHEN
;
Zhenghua HONG
;
Zhangfu WANG
;
Xinbin FENG
;
Weifu CHEN
;
Haixiao CHEN
- From:
Chinese Journal of Orthopaedics
2021;41(1):8-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness and safety of middle-column preserved pedicle subtraction closing-opening wedge osteotomy for the treatment of stiff kyphosis.Methods:From January 2016 to April 2018, 12 patients with stiff kyphosis in our department were treated with middle-column preserved pedicle subtraction closing-opening wedge osteotomy. The patients' operative time, intraoperative blood loss, postoperative drainage, surgical complications, low back pain and leg pain visual analogue scale (VAS), Oswestry dysfunction index (ODI) score, and SF-36 were recorded.These parameters were compared at preoperative, postoperative, and at the final follow-up. Coronal parameters included lumbar scoliosis Cobb angle, C 7 vertebral body center to humeral vertical line distance (C 7PL-CSVL), whilesagittal parameters includedlumbar Lordosis (LL), sacral slope (SS), pelvic tilt (PT), and sagittalvertical axis (SVA). Results:All of 12 patients successfully completed the operation.The mean operation time was 238.20±65.95 min, the mean intraoperative blood loss was 440.50±133.60 ml.The patients’ODI score was 65.92%±6.96% at the preoperative, and 21.00%±3.19% at the final follow-up. The difference was statistically significant ( t=20.32, P<0.0001).The VAS score of back pain was 6.00±0.95 at preoperative, 2.33±0.89 at 3 months postoperatively, and 1.42±0.51 at the final follow-up. The VAS score of leg pain was 6.91±1.24 at preoperative, 2.50±1.00 at 3 months postoperatively, and1.50±0.52 at the final follow-up. There was significant difference in SF-36 at preoperative and at final follow-up ( P<0.05). The differences in LL, SS, PT and SVA at the preoperative and at final follow-up were statistically significant ( F=17.47, P<0.001; F=5.015, P=0.0125; F=14.66, P<0.001; F=81.11, P<0.001) . There was significant difference in lumbar scoliosis Cobb angle and C 7PL-CSVL at the preoperative and at final follow-up ( F=87.19, P<0.001; F=100.9, P<0.001) . Conclusion:The advantages of this surgical procedure includesimple operation, reducedsurgery time, and shorten intraoperative bleeding, which can effectively relief clinical symptoms, improve the quality of life, correctkyphosis, and maintain the patient's spinal-pelvic balance.
