Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up

its management can be quite challenging. Pedicle subtraction osteotomy includes posteriorly based wedge resection of the posterior column and both pedicles, with the hinge located at the anterior cortex of the vertebral body. It has been developed to achieve significant deformity correction. It does...

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Autor principal:	Ahmed Sleem
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	Osteotomy posttraumatic kyphosis Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/2930654d74bd4be4a8a0635e0cba4b95
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spelling	oai:doaj.org-article:2930654d74bd4be4a8a0635e0cba4b952021-12-02T00:13:28ZModified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-UpDOI:10.21608/ESJ.2017.55202314-89502314-8969https://doaj.org/article/2930654d74bd4be4a8a0635e0cba4b952017-01-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_5520.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969its management can be quite challenging. Pedicle subtraction osteotomy includes posteriorly based wedge resection of the posterior column and both pedicles, with the hinge located at the anterior cortex of the vertebral body. It has been developed to achieve significant deformity correction. It does not involve the adjacent disc which is usually affected and represents a cause of pain, neurological compression and progression of deformity. Modified pedicle subtraction osteotomy (MPSO) including resection of posteriorly based wedge of posterior column and both pedicles together with the damaged disc to achieve correction and solid fusion between the affected vertebra and the adjacent one. It seems to be more suitable for the management of PTK. Purpose: The purpose of this prospective study is to review our experience with modified Pedicle subtraction osteotomy (MPSO) technique for the management of thoracolumbar posttraumatic kyphosis (PTK). Study Design: Prospective cohort clinical case study. Patients and Methods: From February 2010 to July 2014, 14 consecutive patients with PTK were managed by MPSO. The patients were followed clinically and radiologically. Back pain VAS, Denis work scale and regional kyphotic angle (RKA) were recorded and analyzed preoperatively, postoperative and at the latest follow up. Results: The study included 14 patients with an average age of 38.43±6.63 (26 - 48) years. The follow up period was 46.29±15.45 months. The average operative time was 286.43±12.74 minutes and per-operative blood loss was 1017.86±198.75 ml. Back pain VAS improved from 8.21±0.77 preoperatively to 2.50±0.73 at the last follow-up (P=0.034), and the Denis work scale improved from 4.43±0.49 preoperatively to 1.64±1.23 at the last follow-up (P=0.022). Neurological improvement occurred in one patient from ASIA grade D to E with no postoperative deterioration in any case. The regional kyphotic angle (RKA) significantly improved from 42.07±5.28° preoperatively to 2.67±2.58° after surgery (P=0.04) with a mean correction of 38.47±5.42°. The loss of correction was 1.92±0.73° at the latest follow-up. The complications included 2 dural tears and 3 postoperative wound infections. Conclusion: MPSO technique provides significant correction of patient’s kyphosis with a risk profile similar to a standard PSO procedure. (2016ESJ122)Ahmed SleemEgyptian Spine AssociationarticleOsteotomyposttraumatickyphosisNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 21, Iss 1, Pp 6-13 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Osteotomy posttraumatic kyphosis Neurology. Diseases of the nervous system RC346-429
spellingShingle	Osteotomy posttraumatic kyphosis Neurology. Diseases of the nervous system RC346-429 Ahmed Sleem Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up
description	its management can be quite challenging. Pedicle subtraction osteotomy includes posteriorly based wedge resection of the posterior column and both pedicles, with the hinge located at the anterior cortex of the vertebral body. It has been developed to achieve significant deformity correction. It does not involve the adjacent disc which is usually affected and represents a cause of pain, neurological compression and progression of deformity. Modified pedicle subtraction osteotomy (MPSO) including resection of posteriorly based wedge of posterior column and both pedicles together with the damaged disc to achieve correction and solid fusion between the affected vertebra and the adjacent one. It seems to be more suitable for the management of PTK. Purpose: The purpose of this prospective study is to review our experience with modified Pedicle subtraction osteotomy (MPSO) technique for the management of thoracolumbar posttraumatic kyphosis (PTK). Study Design: Prospective cohort clinical case study. Patients and Methods: From February 2010 to July 2014, 14 consecutive patients with PTK were managed by MPSO. The patients were followed clinically and radiologically. Back pain VAS, Denis work scale and regional kyphotic angle (RKA) were recorded and analyzed preoperatively, postoperative and at the latest follow up. Results: The study included 14 patients with an average age of 38.43±6.63 (26 - 48) years. The follow up period was 46.29±15.45 months. The average operative time was 286.43±12.74 minutes and per-operative blood loss was 1017.86±198.75 ml. Back pain VAS improved from 8.21±0.77 preoperatively to 2.50±0.73 at the last follow-up (P=0.034), and the Denis work scale improved from 4.43±0.49 preoperatively to 1.64±1.23 at the last follow-up (P=0.022). Neurological improvement occurred in one patient from ASIA grade D to E with no postoperative deterioration in any case. The regional kyphotic angle (RKA) significantly improved from 42.07±5.28° preoperatively to 2.67±2.58° after surgery (P=0.04) with a mean correction of 38.47±5.42°. The loss of correction was 1.92±0.73° at the latest follow-up. The complications included 2 dural tears and 3 postoperative wound infections. Conclusion: MPSO technique provides significant correction of patient’s kyphosis with a risk profile similar to a standard PSO procedure. (2016ESJ122)
format	article
author	Ahmed Sleem
author_facet	Ahmed Sleem
author_sort	Ahmed Sleem
title	Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up
title_short	Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up
title_full	Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up
title_fullStr	Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up
title_full_unstemmed	Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up
title_sort	modified pedicle subtraction osteotomy for posttraumatic kyphosis: long term follow-up
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/2930654d74bd4be4a8a0635e0cba4b95
work_keys_str_mv	AT ahmedsleem modifiedpediclesubtractionosteotomyforposttraumatickyphosislongtermfollowup
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Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up

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