Posterior pedicle subtraction osteotomy at the apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine: a medium-term curative effects

doi:10.3969/j.issn.2095-4344.2016.04.013

Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (4): 529-533.doi: 10.3969/j.issn.2095-4344.2016.04.013

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Posterior pedicle subtraction osteotomy at the apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine: a medium-term curative effects

Ao Shuang¹, Jia Yi-ming¹, Leng Hui¹, Zhao Yu², Sui Yu-xin¹, Zhang Hao¹

¹Spine Surgery, Chifeng Municipal Hospital, Chifeng 024000, Inner Mongolia Autonomous Region, China; ²Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100000, China

Received:2015-11-18 Online:2016-01-22 Published:2016-01-22
Contact: Leng Hui, Associate professor, Chief physician, Master’s supervisor, Spine Surgery, Chifeng Municipal Hospital, Chifeng 024000, Inner Mongolia Autonomous Region, China Corresponding author: Zhao Yu, Professor, Chief physician, Doctoral supervisor, Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100000, China
About author:Ao Shuang, Master, Attending physician, Spine Surgery, Chifeng Municipal Hospital, Chifeng 024000, Inner Mongolia Autonomous Region, China
Supported by:
the National Natural Science Foundation of China, No. 81572093

Abstract

Abstract:

BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especially to avoid the corresponding spinal nerve injury.

OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine.

METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. All patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in all patients. X-ray films or CT films showed the bone graft fusion during follow-up.

RESULTS AND CONCLUSION: Patients were followed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final follow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final follow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Ao Shuang, Jia Yi-ming, Leng Hui, Zhao Yu, Sui Yu-xin, Zhang Hao. Posterior pedicle subtraction osteotomy at the apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine: a medium-term curative effects[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(4): 529-533.

Figures/Tables 3

References

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Posterior pedicle subtraction osteotomy at the apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine: a medium-term curative effects

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