Treatment of rigid post-traumatic thoracolumbar kyphosis by a novel technique of spinal joints release

Abstract

Objective The purpose of this study was to evaluate the feasibility of a novel technique named spinal joints release (SJR) and observe its efficacy in treating rigid post-traumatic thoracolumbar kyphosis (RPTK).Methods RPTK patients who were treated by SJR with facet resection, limited laminotomy, clearance of the intervertebral space, and release of the anterior longitudinal ligament through the intervertebral foramen from August 2015 to August 2021 were reviewed. Operation time and intraoperative blood loss were recorded. The intraoperative, postoperative, and final follow-up complications were observed. The improvement in VAS score and ODI index were observed. Spinal cord functional recovery was evaluated by ASIA score. Improvement of local kyphosis (Cobb) was evaluated by radiography.Results Forty-three patients were successfully treated by the SJR surgical technique. There were no serious complications. The average operation time was 224 ± 31 min, and intraoperative blood loss was 450 ± 225 mL. All of the patients were followed up with an average of 26 ± 8.5 months. The VAS scores and ODI index improved significantly at the final follow-up. All of the 17 patients with incomplete spinal cord injury achieved more than one grade neurological recovery at the final follow-up. An 87% correction rate of kyphosis was achieved and maintained, with the Cobb angle decreasing from 27.7° preoperatively to 5.4° at the final follow-up.Conclusion Posterior SJR surgery for patients with RPTK has the advantages of less trauma and less blood loss, and kyphosis correction is satisfactory.