Posterior 3-Column Osteotomy for Treatment of Congenital Kyphosis with Multiple Thoracolumbar/Lumbar Anterior Unsegmented Vertebrae: A Comparison Between Patients with Increasing Number of Anterior Unsegmented Vertebrae

被引:1
|
作者
Li, Song [1 ]
Mao, Saihu [1 ]
Ma, Yanyu [1 ]
Zhu, Zezhang [1 ]
Liu, Zhen [1 ]
Shi, Benlong [1 ]
Qiao, Jun [1 ]
Qiu, Yong [1 ]
机构
[1] Nanjing Univ, Dept Orthoped Surg, Div Spine Surg, Affiliated Hosp,Med Sch,Nanjing Drum Tower Hosp, Nanjing, Peoples R China
关键词
3-column osteotomy; Anterior unsegmented vertebrae; Complication; Congenital kyphosis; PEDICLE SUBTRACTION OSTEOTOMY; OPENING WEDGE OSTEOTOMY; COLUMN RESECTION; ANKYLOSING-SPONDYLITIS; SURGICAL-CORRECTION; SAGITTAL IMBALANCE; SPINE; DEFORMITY; SUBLUXATION; MECHANISMS;
D O I
10.1016/j.wneu.2021.12.021
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: A 3-column osteotomy is sometimes challenging in congenital kyphosis (CK) with many anterior unsegmented vertebrae (AUVs). This study compared surgical outcomes of single-level 3-column osteotomy and associated complications in CK with increasing number of AUVs. METHODS: We retrospectively reviewed 25 consecutive patients with AUVs in CK who underwent surgery at a mean age of 16.2 +/- 10.3 years. Patients were stratified into 2 groups according to the number of AUVs: 3 AUVs and >= 4 AUVs. Osteotomy types, surgical outcomes, and related complications were analyzed and compared between groups. RESULTS: The 3 AUVs group comprised 13 patients, and the >= 4 AUVs group comprised 12 patients. Pedicle subtraction osteotomy, grade 4 osteotomy, vertebral column resection, and vertebral column decancellation accounted for 15.4%, 38.5%, 46.1%, and 0% of procedures in the 3 AUVs group and 8.3%, 0%, 83.3%, and 8.3% of procedures in the >= 4 AUVs group. Preoperative focal kyphosis, which was significantly higher in the >= 4 AUVs group (82.9 degrees +/- 28 degrees vs. 59.7 degrees +/- 9.4 degrees , P = 0.010), was corrected in both groups postoperatively. The >= 4 AUVs group had significantly higher remaining kyphosis (33.6 degrees +/- 13.4 degrees vs. 15.1 degrees +/- 9.1 degrees , P< 0.001) with a significantly lower correction rate (61.2% +/- 13.6% vs. 75.0% +/- 15.6%, P = 0.001). The complication rate, mainly involving vertebral subluxation and proximal junctional kyphosis, was significantly higher in the >= 4 AUVs group than the 3 AUVs group (8/12 vs. 1/13, P = 0.004). CONCLUSIONS: Posterior single-level 3-column osteotomy can achieve satisfactory kyphosis correction in CK with 3 AUVs. Decreasing kyphosis correction and increasing surgery-related complications are prone to develop when treating CK with >= 4 AUVs.
引用
收藏
页码:E172 / E183
页数:12
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