Transpedicular wedge resection osteotomy for the treatment of a kyphotic Andersson lesion-complicating ankylosing spondylitis

Royen, Barend J. van; Kastelijns, R. C. A.; Noske, David P.; Oner, F. Cumhur; Smit, Theo H.

doi:10.1007/s00586-005-1008-1

Cited by 27 publications

(25 citation statements)

References 21 publications

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“…The operative or nonoperative treatments often fail, resulting in a three-dimensional deformity at coronal, sagittal, and frontal planes [2,16,29,30]. In contrast to the adolescent scoliosis, which is usually asymptomatic, the adult scoliosis patients usually present with back pain [34,38]. In addition, adult patients are more likely to experience symptoms of spinal stenosis and radiculopathy from osteoarthritis and rotatory subluxation, which may lead to nerve root impingement and stretching.…”

Section: Discussionmentioning

confidence: 99%

A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases

Wang

Zhang

et al. 2008

Eur Spine J

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We report a multilevel modified vertebral column resection (MVCR) through a single posterior approach and clinical outcomes for treatment of severe congenital rigid kyphoscoliosis in adults. Transpedicular eggshell osteotomies and vertebral column resection are two techniques for the surgical treatment of rigid severe spine deformities. The authors developed a new technique combining the two surgical methods as a MVCR, through a single posterior approach, for surgical treatment of severe congenital rigid kyphoscoliosis in adults. Thirteen adult patients with severe rigid congenital kyphoscoliosis deformity were treated by a single posterior approach using a MVCR technique. The surgery processes included a onestage posterior transpedicular eggshell technique first, and then expanded the eggshell technique to adjacent intervertebra space through abrasive reduction of the vertebral cortices from inside out. All posterior vertebral elements were removed including the cortical vertebral bone around the neural canal. Range of resection of the vertebral column at the apex of the deformity included apical vertebra and both cephalic and/or caudal adjacent wedged vertebrae. Totally, 32 vertebrae had been removed in 13 patients, with 2.42 vertebrae being removed on average in each case. The average fusion extent was 7.69 vertebrae. Mean operation time was 266 min with average blood loss of 2,411.54 ml during operation. Patients were followed up for an average duration of 2.54 years. Deformity correction was 59% in the coronal plane (from 79.7°to 32.4°) postoperatively and 33.7°(57% correction) at 2 years followup. In the sagittal plane, correction was from preoperative 85.9°to 27.5°immediately after operation, and 32.0°at 2 years follow-up. Postoperative pain was reduced from preoperative 1.77 to 0.54 at 2 years follow-up in visual analog scale. SRS-24 scale was from 38.2 preoperatively to 76.9 at 2 years follow-up postoperative. Complications were encountered in four patients (30.7%) with transient neurology that spontaneously improved without further treatment within 3 months. MVCR technique through a single posterior approach is an effective procedure for the surgical treatment of severe congenital rigid kyphoscoliosis in adults.

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Section: Discussionmentioning

confidence: 99%

A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases

Wang

Zhang

et al. 2008

Eur Spine J

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“…Persistent and abnormal motion at the stress fracture site makes spontaneous healing difficult, which leads to the formation of pseudarthrosis [20]. Pseudarthrosis may complicate with a progressive kyphotic deformity causing sagittal imbalance and considerable disturbances of posture [16,23].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment is mandatory for patients with ASrelated thoracolumbar pseudarthrosis, who present with painful thoracolumbar kyphosis, neurological deficits, and sagittal imbalance [16,23]. The goals of surgical treatment are to restore sagittal alignment, to correct the kyphotic deformity and to achieve solid fusion of pseudarthrosis [23].…”

Section: Introductionmentioning

confidence: 99%

“…The goals of surgical treatment are to restore sagittal alignment, to correct the kyphotic deformity and to achieve solid fusion of pseudarthrosis [23]. However, there is controversy regarding the optimal surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is controversy regarding the optimal surgical procedure. Some authors believe that anterior fusion allows direct access to the anterior lesion [11,16], whereas others consider that pseudarthrosis can be treated effectively by posterior, transpedicular wedge resection osteotomy at the level of pseudarthrosis and fixation without supplemental anterior fusion [4,23]. Most surgeons recommend combined anterior and posterior approach for the treatment of pseudarthrosis and kyphotic deformity [6,16].…”

Section: Introductionmentioning

confidence: 99%

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