Computer navigation-assisted surgical treatment with osteotomy for upper thoracic kyphosis

doi:10.3969/j.issn.2095-4344.2549

Abstract

Abstract:

BACKGROUND: The biomechanical characteristics of kyphosis of the upper thoracic vertebra are unique. Decompression and internal fixation are relatively difficult. Previous relevant studies and case reports are few, and there is a lack of research on correction of kyphosis of the upper thoracic section with the assistance of computer navigation.

OBJECTIVE: To explore the clinical effect of computer navigation-assisted surgical treatment of upper thoracic kyphosis by screws and osteotomy.

METHODS: Totally 18 patients with kyphotic deformity of the spine (T₁-T₄) were admitted in Beijing Jishuitan Hospital from June 2011 to June 2018, including 11 males and 7 females, aged 12 to 59 years. They were all treated with computer-assisted surgical treatment with PSO osteotomy. Local Cobb angle of the upper thoracic kyphosis was determined during final follow-up. Cervical visual analogue scale, Nurick grades, EMS scores and satisfaction of the surgery were evaluated. This study was approved by the Ethics Committee of Beijing Jishuitan Hospital (approval No. 201709-23).

RESULTS AND CONCLUSION: (1) A total of 18 patients were followed up for 6-90 months at an average time of (33.73±35.33) months. (2) The local Cobb angle of 18 patients at the last follow-up was significantly improved [(47.32±9.92)°, (24.01±7.64)°, P < 0.001]. Cervical visual analogue scale score at the last follow-up was significantly lower than that before surgery (3.64±2.16, 0.73±1.01, P < 0.001). Nurick score at the last follow-up was significantly lower than that before surgery (2.91±0.94, 0.82±1.47, P < 0.001). EMS score at the last follow-up was significantly higher than that before surgery (14.45±0.93), 17.09±1.45, P < 0.001). (3) Surgical satisfaction was excellent (n=16) or good (n=2). (4) At the last follow-up, 18 patients had no adverse reactions related to implants, and the wound healed well without screw loosening. (5) The results showed that reasonable osteotomy correction with computer-assisted surgery and PSO osteotomy could effectively treat kyphosis of upper thoracic segment.

Key words: upper thoracic, kyphotic deformity, PSO osteotomy, computer navigation-assisted surgery, pedicle screw fixation, function, satisfaction, Cobb angle

CLC Number:

He Da, Li Zuchang, Zhao Jingwei, Tian Wei.

Computer navigation-assisted surgical treatment with osteotomy for upper thoracic kyphosis [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(12): 1859-1863.

Figures/Tables 3

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