Changes in cardiac function after pedicle subtraction osteotomy in patients with a kyphosis due to ankylosing spondylitis

Fu, Jun; Song, Kai; Zhang, Y. G.; Zheng, Guoyan; Zhang, G. Y.; Liu, C.; Wang, Y.

doi:10.1302/0301-620x.97b10.35808

Cited by 14 publications

(7 citation statements)

References 36 publications

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“…At the same time, the correlation analysis showed that the GK angle was signi cantly negatively correlated with the left atrioventricular cavity diameter (LVDD, LVSD), and the correlation coe cients were -0.304 and -0.341, respectively. It con rmed that the size of the GK angle in AS patients could have a certain impact on the cardiac structure, consistent with the previous research results [20,21] .…”

Section: Effect Of Gk Angle On Cardiac Functionsupporting

confidence: 91%

Effect of kyphosis in ankylosing spondylitis on cardiopulmonary function

yang¹,

xia²,

huang³

et al. 2022

Preprint

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Purpose: To analyze the characteristics of cardiopulmonary function in patients with ankylosing spondylitis (AS), and explore the influence of global kyphosis (GK) on cardiopulmonary function. Method: Clinical data of 46 AS patients with kyphosis admitted to our hospital from October 2021 to October 2022 were retrospectively analyzed. According to the to global kyphosis Angle, they were divided into severe group (GK > 95°), 23 cases in the moderate group (80° ≤ GK ≤ 95°). Cardiac structure, function and lung function parameters were compared between the two groups, and the effects of GK Angle on other parameters were analyzed by Pearson or Spearman correlation analysis. Result: The cardiac structure and function measurements in both groups were within the normal range, and the atrioventricular size in the severe group was significantly smaller than that in the moderate group (P < 0.05), left ventricular diastolic function parameters E/A, e’/a’ were significantly lower than those in moderate group (P < 0.05), and E/e’ was significantly higher than that in moderate group (P < 0.05). The lung function of the two groups was decreased to varying degrees. The restrictive ventilation function, small airway function and ventilation function parameters of the severe group were significantly lower than those of the moderate group (P < 0.05). Correlation analysis showed that GK Angle was significantly negatively correlated with left atrioventricular size (LAD, LVDD, LVSD) and diastolic function parameters (E/A, e’/a’) in AS patients (P < 0.05); GK Angle was negatively correlated with restrictive ventilation parameters in AS patients (P < 0.05). Conclusion: The GK Angle of AS affects the heart structure and diastolic function. The larger the GK Angle is, the smaller the left and right atventricle diameters are. In addition, GK Angle also affects left ventricular diastolic function. GK Angle is related to the degree of lung function impairment, and the larger the GK Angle, the worse the lung function.

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Section: Effect Of Gk Angle On Cardiac Functionsupporting

confidence: 91%

Effect of kyphosis in ankylosing spondylitis on cardiopulmonary function

yang¹,

xia²,

huang³

et al. 2022

Preprint

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“…Surgical correction, such as a spinal osteotomy, may be the appropriate option for the treatment of AS patients with a severe kyphosis deformity [8, 9, 23]. As proven by our research group, spinal osteotomies not only corrected the sagittal deformity but also significantly increased pulmonary function [24, 25], digestive function by relieving abdominal viscera compression [19, 26], cardiac function [27], and sexual activity [28] of patients with AS.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, an osteotomy at the apex vertebra should achieve a better corrective effect [27, 31, 32]. With the same correction angle, an osteotomy at the lower level vertebra can achieve greater safety [33].…”

Section: Discussionmentioning

confidence: 99%

Clinical results and surgery tactics of spinal osteotomy for ankylosing spondylitis kyphosis: experience of 428 patients

et al. 2019

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ObjectiveTo report the clinical results and surgical tactics of spinal osteotomy for ankylosing spondylitis (AS) kyphosis based on the experiences of 428 patients.MethodsFrom January 2003 to January 2015, a total of 428 patients suffering from AS kyphosis who underwent a one- or two-level pedicle subtraction osteotomy (PSO) or vertebral column decancellation (VCD) osteotomy in our hospital were reviewed. Pre- and postoperative radiological parameters and the chin-brow vertical angle (CBVA) were measured. Intraoperative, postoperative, and general complications were recorded.ResultsAll patients could walk with horizontal vision and lie on their backs postoperatively. The pre- and postoperative average global kyphosis (GK) angles were corrected from 82.6 to 12.7° (p = 0.000) in the two-level group and from 55.8 to 9.6° (p = 0.000) in the one-level group, respectively. The mean sagittal vertical axis (SVA) improved from 29.4 to 8 cm (p = 0.000) in the two-level group and from 18.0 to 4.3 cm (p = 0.000) in the one-level group. The CBVA improved from 68.3 to 8.2° (p = 0.000) in the two-level group and from 46.2 to 4.2° (p = 0.000) in the one-level group. Although no major acute complications such as death or complete paralysis occurred, the complication rate was 6.5% in the one-level group and 23.6% in the two-level group.ConclusionSpinal osteotomy, such as PSO and VCD, can improve the quality of life of AS patients as well as correct kyphotic deformities. The one-level spinal osteotomy showed a lower complication rate, while two-level spinal osteotomy was a relatively aggressive procedure that was more suitable in correcting severe AS kyphotic deformities.

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“…[21,22] Osteotomy surgery can not only correct the sagittal imbalance of the spine but also improve cardiopulmonary and digestive function. [5,23,24] At present, several corrective osteotomies were reported for the treatment of AS-related kyphosis: SPO, PSO, Ponte, and VCR, among which SPO and PSO are the most widely used procedure. SPO is a posterior chevron-shaped osteotomy that obtains 10 ° correction with a single level.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Severe Kyphotic Deformity Secondary to Ankylosing Spondylitis by Staged Osteotomy in Lateral Decubitus Position: A Retrospective Study

Zhong¹,

Hu²,

Zhao³

et al. 2021

Preprint

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Background: Patients are often complicated with severe kyphotic deformity (Cobb>100 °) in the advanced stage of ankylosing spondylitis (AS). Corrective osteotomy based on prone position seems to be the only effective treatment. Sometimes, it is difficult to place AS patients with severe kyphosis in a prone position even with a specially prepared folding bed.Methods: 23 patients who underwent staged osteotomy in lateral position from October 2015 to June 2017 were analyzed. All but one patient underwent a single-level Ponte osteotomy in the first stage surgery; pedicle subtraction osteotomy was then carried out in the second stage surgery. The average follow-up was 30.8±4.6 months. The global kyphosis (GK), thoracic kyphosis (TK), lumbar lordosis (LL), the sagittal vertical axis (SVA), the osteotomized vertebra intervertebral angle (OVI), Chin-brow vertical angle (CBVA), the Oswestry Disability Index (ODI) score and the Scoliosis Research Society-22 Patient Questionnaire (SRS-22), were compared pre-and post-operation.Results：All kyphosis parameters were significantly improved (all P< 0.05). The GK was corrected from 115.0± 13.4 ° to 46.5 ± 9.0 ° postoperatively, with a mean correction of 68.5 °. The SVA was improved from 21.2 ± 5.1 cm to 5.1 ± 1.8 cm postoperatively. The CBVA was corrected from 64.1±23.2 ° to 5.7±10.6 ° postoperatively; The OVI was corrected from 9.0±2.7 ° to -20.1±5.6 ° postoperatively. There were significant improvements in the ODI and SRS-22 (all P< 0.05). 4 mild complications were observed perioperatively.Conclusion：Satisfactory correction is safely achieved by staged osteotomy in lateral decubitus position in AS patients with severe kyphosis, which can not only correct the sagittal imbalance of the spine with acceptable complications but also facilitate the placement of intraoperative position.

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Changes in cardiac function after pedicle subtraction osteotomy in patients with a kyphosis due to ankylosing spondylitis

Cited by 14 publications

References 36 publications

Effect of kyphosis in ankylosing spondylitis on cardiopulmonary function

Effect of kyphosis in ankylosing spondylitis on cardiopulmonary function

Clinical results and surgery tactics of spinal osteotomy for ankylosing spondylitis kyphosis: experience of 428 patients

Treatment of Severe Kyphotic Deformity Secondary to Ankylosing Spondylitis by Staged Osteotomy in Lateral Decubitus Position: A Retrospective Study

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