Comparison of Smith-Petersen Osteotomy and Pedicle Subtraction Osteotomy for the Correction of Thoracolumbar Kyphotic Deformity in Ankylosing Spondylitis

Liu, Hui; Yang, Changsheng; Zheng, Zhaomin; Ding, Wenbin; Wang, Jianru; Wang, Hua; Li, Sibei

doi:10.1097/brs.0000000000000815

Cited by 65 publications

(73 citation statements)

References 38 publications

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“…Additionally, the continued movement at the fracture site eventually contributes to the development of pseudoarthrosis [18]. There are three surgical strategies for kyphosis in AS patients with pathological fractures or pseudoarthroses, and the advantages and disadvantages are summarized below:Anterior debridement only: Anterior debridement is especially suitable for eliminating the compression in front of the spine as, for example, in spinal tuberculosis and spinal metastatic carcinoma [19]. The surgeon could have an ideal biomechanical environment via anterior approach [20], and the surgical procedure to eliminate the stress in the front of the spine is much easier [21, 22].…”

Section: Discussionmentioning

confidence: 99%

“…Anterior debridement only: Anterior debridement is especially suitable for eliminating the compression in front of the spine as, for example, in spinal tuberculosis and spinal metastatic carcinoma [19]. The surgeon could have an ideal biomechanical environment via anterior approach [20], and the surgical procedure to eliminate the stress in the front of the spine is much easier [21, 22].…”

Section: Discussionmentioning

confidence: 99%

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Treatment of kyphosis in ankylosing spondylitis by osteotomy through the gap of a pathological fracture: a retrospective study

et al. 2016

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BackgroundSurgical interventions are commonly advocated for correcting kyphotic deformities and relieving severe back pain in ankylosing spondylitis (AS) patients. The aim of this study was to evaluate the clinical outcome of osteotomy performed through the gap of a pathological fracture for the treatment of kyphosis in ankylosing spondylitis and to introduce the key points of this novel surgical approach.MethodsFrom January 1, 2010, to December 31, 2014, 13 consecutive AS patients who were treated with osteotomy through the fracture gap were retrospectively reviewed. Patients underwent the radiographic assessment of sagittal balance parameters. Visual analog scale (VAS) scores were used to assess improvement in back pain.ResultsThe average follow-up time was 2 years and 1 month. The median operation time was 280 min (range, 220–460 min). The mean blood loss was 1100 mL (range, 820–1300 mL). No major acute complications such as death or complete paralysis occurred. There were no neurologic complications or cerebrospinal fluid leaks in any patient. One patient had postoperative wound infection, which subsided after a switch of antibiotics. The global kyphosis Cobb angle of patients decreased from the preoperative 55.8° ± 11.0° to 23.2° ± 6.7° (P < 0.001) after surgery. The C7 plumb line was used to assess global balance; its relationship with the posterosuperior corner of the sacrum decreased from 166 ± 37 mm to 111 ± 20 mm (P < 0.001). The thoracolumbar kyphosis Cobb angle decreased from 51.0° ± 9.9° to 21.6° ± 11.0° (P < 0.001). VAS scores for back pain decreased from 7.2 ± 1.2 to 2.1 ± 1.1 (P < 0.001). Lumbar lordosis increased from 5.7° ± 23.2° to 10.5° ± 29.2° (P = 0.001).ConclusionsOsteotomy through the pathological fracture gap is a safe and effective surgical procedure for kyphosis correction and improvement of back pain in AS patients with pathological fractures. A significant kyphosis correction and improvement of back pain can be achieved with this surgical procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of kyphosis in ankylosing spondylitis by osteotomy through the gap of a pathological fracture: a retrospective study

et al. 2016

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“…The effect of complex spinal reconstruction on AS patients [13][14][15][16] and their gait pattern 2,7,12 are well documented. However, there is limited literature on whether complex spinal reconstruction effects on spine and lower extremity neuromuscular control and biomechanics during gait in patients with AS.…”

Section: Surgical Interventionmentioning

confidence: 99%

Clinical Gait Analysis on a Patient Undergoing Surgical Correction of Kyphosis from Severe Ankylosing Spondylitis

Haddas

Belanger

2017

Int J Spine Surg

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“…Currently, conservative therapy of DS is considered to be ineffective, so surgical treatment is needed in most cases [5] . Despite preferable clinical outcomes with the conventional posterior osteotomy and orthopedic internal xation, problems such as long operative duration, large intraoperative bleeding volume, high technical requirements and slow postoperative recovery are present, which can be hardly tolerable by the physical condition of middle-aged and elderly patients [6][7][8][9] . Accordingly, the concept of minimally invasive spinal surgery has emerged.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of oblique lateral lumbar interbody fusion combined with posterior navigation and long segment internal fixation in the treatment of degenerative scoliosis

Lou¹,

Fang²,

Hong³

et al. 2020

Preprint

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Background ：To assess the short-term clinical outcomes of oblique lateral lumbar interbody fusion (OLIF) combined with multiple level fixation with the guidance of posterior "O" arm CT navigation for degenerative scoliosis. Methods ：A total of 15 patients (3 males and 12 females; average age: 62.2±5.3 years) with degenerative scoliosis were enrolled in our study. All patients were treated with OLIF combined with posterior "O" arm CT navigation and long segment (T 10 -L 5 ) internal fixation during Apr. 2016 and Dec. 2017. Collected perioperative data included surgery time, blood loss, excellent rate of intraoperative pedicle screw. Coronal Cobb angle, lumbar lordosis (LL), intervertebral space height, sagittal balance (SVA) were measured by plain radiograph. Accuracy of pedicle screw placement and intervertebral fusion was investigated with postoperative CT. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical efficacy of surgery. Results ： All patients were followed for 12-25 months (16.5±5.3 months).The OLIF operation time was (98.7±16.8) min, and the blood loss was (50.2±10.7) ml. The posterior "O" arm CT-navigated long segment internal fixation was (101.5 ± 23.4) min, and the blood loss was (63.1 ± 19.7) ml. The total operation time was (200.2±40.2) min, and the blood loss was (113.3±30.4) ml. Coronal Cobb angle, LL, intervertebral space height, SVA, VAS, ODI at the last follow-up were 5.5°± 3.1°, 39.3°± 9.1°, (10.9±1.2) mm, (25.1±10.9) mm, (1.3± 0.8)and(15.8±4.5)%, respectively, showing statistically significant differences ( P <0.05). The "O" arm CT navigation has 240 nails, and the excellent rate of three-dimensional scanning of the "O" arm during surgery is 96%. Lumbar CT showed lumbar fusion at the 6-month postoperative period. Conclusion ： The short-term clinical outcomes of oblique lateral lumbar interbody fusion combined with posterior "O" arm CT-navigated long segment internal fixation for degenerative scoliosis are satisfactory, with advantages like minimal invasiveness, accurate navigation, high bone fusion rate and few complications. Keywords ：Scoliosis; Surgery,computer-assisted; Spine fusion

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Comparison of Smith-Petersen Osteotomy and Pedicle Subtraction Osteotomy for the Correction of Thoracolumbar Kyphotic Deformity in Ankylosing Spondylitis

Abstract: 4.

Cited by 65 publications

References 38 publications

Treatment of kyphosis in ankylosing spondylitis by osteotomy through the gap of a pathological fracture: a retrospective study

Treatment of kyphosis in ankylosing spondylitis by osteotomy through the gap of a pathological fracture: a retrospective study

Clinical Gait Analysis on a Patient Undergoing Surgical Correction of Kyphosis from Severe Ankylosing Spondylitis

Clinical value of oblique lateral lumbar interbody fusion combined with posterior navigation and long segment internal fixation in the treatment of degenerative scoliosis

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