Application of staged three-column osteotomy in the surgical correction of scoliosis
10.3969/j.issn.1004-406X.2025.05.03
- VernacularTitle:脊柱三柱分步截骨术在脊柱侧凸矫形手术中的应用
- Author:
Kai YANG
1
;
Lin GAO
1
;
Chaoshuai FENG
1
Author Information
1. 西安交通大学附属红会医院 脊柱病医院 710000西安市
- Publication Type:Journal Article
- Keywords:
Scoliosis;
Osteotomy;
Neurologic injury;
Complication
- From:
Chinese Journal of Spine and Spinal Cord
2025;35(5):470-476
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the efficacy and safety of staged three-column osteotomy(S-3CO)with posterior column connection preserved in the corrective surgery for scoliosis.Methods:The clinical data of 18 patients(7 males and 11 females,11.8±7.7 years old,followed up for 37.5±12.4 months)with scoliosis treated with S-3CO in our hospital from January 2015 to December 2022 were retrospectively analyzed(S-3CO group).The Cobb angle of the main curve,the horizontal distance between C7 and central sacral vertical line(C7-CSVL)and the sagittal vertical axis(SVA),regional Cobb angle(RCA),regional kyphosis angle(RKA)of the patients in the S-3CO group were collected and compared before operation and at the final follow-up.The complications were analyzed.15 patients with scoliosis who received the traditional three-column osteotomy(3CO)technique during the same period were analyzed(3CO group).There were no statistical difference between the two groups in age,gender,osteotomy grade,and number of fixed segments(P＞0.05).The operative time and the blood loss volume were compared between the two groups.Results:The preoperative Cobb angle of the main curve was 66.7°±23.9°,RCA was 35.3°±6.7°,and RKA was 25.2°±14.2° of the patients in the S-3CO group.The final follow-up Cobb angle of the main curve was 25.7°±13.3°,RCA was 17.6°±6.3°,and RKA was 12.6°±10.6°.The differences in the values between the final follow-up and preoperation were significantly different(P＜0.05).The preoperative C7-CSVL and SVA were 27.9±14.5mm and 29.0±8.7mm,respectively,and 12.7±5.5mm and 17.4±5.6mm respectively at the final follow-up,with statistical differences(P＜0.05).A total of 3 patients in S-3CO group had neuromonitoring alarms during the operation,and 1 of whom had postoperative neurological complication,which was recovered from grade 2 to grade 4 in muscle strength of the right lower limb at 2 years follow-up after conservative treatment.The operative time of S-3CO group was significantly shorter than that of the 3CO group(358.3±140.2min vs 416.3±121.2min,P＜0.05),and the blood loss volume was significantly less than that of the 3CO group(850.0±359.3mL vs 977.3±236.4mL,P＜0.05).Conclusions:By preserving part of the posterior column connection,S-3CO can achieve sufficient local correction and improve the overall corrective efficiency of scoliosis.Preserving the connection and protection of the posterior structure during osteotomy reduces the risk of neurologic injury.
