Modified sequential correction technique combined 3-columns osteotomy: a safe and efficient surgical strategy for severe kyphoscoliosis
10.3760/cma.j.cn121113-20220330-00148
- VernacularTitle:三柱截骨区优先矫形技术治疗严重脊柱侧后凸畸形的疗效
- Author:
Chen LING
1
;
Zhen LIU
;
Zongshan HU
;
Kiram ABDUKAHAR
;
Yanjie XU
;
Ziyang TANG
;
Zhikai QIAN
;
Zezhang ZHU
;
Yong QIU
Author Information
1. 南京医科大学鼓楼临床医学院骨科，脊柱外科，南京 210008
- Keywords:
Scoliosis;
Kyphosis;
Osteotomy;
Orthopedic procedures;
Postoperative complications
- From:
Chinese Journal of Orthopaedics
2022;42(17):1122-1129
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and effects of modified sequential correction technique combined 3-columns osteotomy for severe kyphoscoliosis.Methods:A retrospective analysis was performed on 18 patients (7 males and 11 females) with severe kyphosis who received modified sequential correction technique combined 3-columns osteotomy in our hospital from June 2019 to April 2020. Preoperative, postoperative and final follow-up clinical and imaging outcomes were evaluated.Results:In this cohort, the average fixed segment was 11.2±3.8. The average operative duration was 401.9±68.9 min and the average intraoperative blood loss was 2 418.8±736.9 ml. The Cobb angle was improved significantly from 65.0°±16.4° pre-operatively to 41.6°±14.1° post-operatively. At final follow-up, it was 41.4°±14.3°, which was not significantly different from that after operation. Global kyphosis (GK) was 65.5°±20.8° pre-operatively and 28.1°±13.8° post-operatively with correction rate of 57.8%±17.8%. However, GK was 29.3°±14 .2° at postoperative 1 year , which was not significantly different from that after operation. There was no significant difference in C 7PL-CSVL ( F=0.449 , P=0.642) or SVA ( F=3.519, P=0.058) among the three time points. There was no alter of SEP and MEP observed during operation. Four patients had temporary lower limb numbness after operation, while the symptoms disappeared at 6 months after operation. There was no instrumental failure during the follow-up. Conclusion:Patients with severe kyphoscoliosis can obtain satisfied local correction by undergoing modified sequential correction technique combined 3-columns osteotomy without significant loss of correction at 1 year after operation. It can effectively avoid instability and dislocation of the osteotomy site and massive bleeding during the operation. As a simplified surgical procedure, it can reduce the difficulty of rod loading without prolonged operation duration. Further, this technique can ensure lower incidence of neurological complications and rod failure.
