Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.

Background Data: Thoracolumbar fractures nowadays are considered the commonest spinal fractures and its treatment remains one of the major controversies. Post-traumatic kyphosis (PTK) is considered the commonest serious complication of poorly managed thoracolumbar fractures which can affect the pati...

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Autores principales:	Ahmed El Naggar, MD., Shamel Elgawhary, MD., Tarek ElHewala, MD.
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2018
Materias:	post-traumatic kyphosis vertebral column resection vertebral osteotomy thoracolumbar Fracture Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/4657b9ebbadc44da98ae0854c2b5e36f
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spelling	oai:doaj.org-article:4657b9ebbadc44da98ae0854c2b5e36f2021-12-02T03:00:26ZPosterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.10.21608/esj.2019.5021.10642314-89502314-8969https://doaj.org/article/4657b9ebbadc44da98ae0854c2b5e36f2018-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_26435.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Thoracolumbar fractures nowadays are considered the commonest spinal fractures and its treatment remains one of the major controversies. Post-traumatic kyphosis (PTK) is considered the commonest serious complication of poorly managed thoracolumbar fractures which can affect the patient health quality of life. Different corrective osteotomy techniques are described to correct this deformity but with limited correction in sever angular kyphotic deformity. Our hypothesis was, among several osteotomies described to correct kyphosis, vertebral column resection (VCR) provides the highest angle of correction required to manage patients with severe PTK. Purpose: To evaluate the safety and efficacy of posterior VCR in the treatment of patients with severe degrees of post-traumatic thoracolumbar kyphosis and determine the degree of correction in sagittal imbalance and its relationship with functional outcome of the patients. Study Design: This prospective clinical case study. Patients and Methods: Twelve patients suffering from PTK and managed with posterior VCR were recruited for this study. The mean local kyphosis angle (LKA) was 64.1±6.3ᴼ. Outcome measures were Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) and radiological using local kyphosis angle (LKA), global kyphosis (GK), lumbar lordosis (LL) and sagittal vertical axis (SVA). The mean follow up time was 13.5±2 months. Results: The mean LKA and SVA score improved from 64.1± 6.3o and 52.6±8.3mm preoperatively to 8.8±3.4o and 13.1±4.8mm postoperatively, respectively. All were statistically significant. Functionally, the VAS score of back pain significantly reduced from 6.8±0.9 to 1.7±0.8 and the Oswestry Disability Index significantly improved from 59.8±7.5 to 11.6±3.4. No major complications were reported apart from intraoperative dural tear in 2 patients, superficial infection in one patient, deep infection in one patient and temporary paraparesis in one patient. Conclusion: Posterior VCR can provide satisfactory correction in severe PTK and improvement in functional outcome with appropriate application and fine surgical technique. (2018ESJ165) Ahmed El Naggar, MD., Shamel Elgawhary, MD., Tarek ElHewala, MD.Egyptian Spine Associationarticlepost-traumatic kyphosisvertebral column resectionvertebral osteotomythoracolumbar FractureNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 28, Iss 1, Pp 48-58 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	post-traumatic kyphosis vertebral column resection vertebral osteotomy thoracolumbar Fracture Neurology. Diseases of the nervous system RC346-429
spellingShingle	post-traumatic kyphosis vertebral column resection vertebral osteotomy thoracolumbar Fracture Neurology. Diseases of the nervous system RC346-429 Ahmed El Naggar, MD., Shamel Elgawhary, MD., Tarek ElHewala, MD. Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.
description	Background Data: Thoracolumbar fractures nowadays are considered the commonest spinal fractures and its treatment remains one of the major controversies. Post-traumatic kyphosis (PTK) is considered the commonest serious complication of poorly managed thoracolumbar fractures which can affect the patient health quality of life. Different corrective osteotomy techniques are described to correct this deformity but with limited correction in sever angular kyphotic deformity. Our hypothesis was, among several osteotomies described to correct kyphosis, vertebral column resection (VCR) provides the highest angle of correction required to manage patients with severe PTK. Purpose: To evaluate the safety and efficacy of posterior VCR in the treatment of patients with severe degrees of post-traumatic thoracolumbar kyphosis and determine the degree of correction in sagittal imbalance and its relationship with functional outcome of the patients. Study Design: This prospective clinical case study. Patients and Methods: Twelve patients suffering from PTK and managed with posterior VCR were recruited for this study. The mean local kyphosis angle (LKA) was 64.1±6.3ᴼ. Outcome measures were Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) and radiological using local kyphosis angle (LKA), global kyphosis (GK), lumbar lordosis (LL) and sagittal vertical axis (SVA). The mean follow up time was 13.5±2 months. Results: The mean LKA and SVA score improved from 64.1± 6.3o and 52.6±8.3mm preoperatively to 8.8±3.4o and 13.1±4.8mm postoperatively, respectively. All were statistically significant. Functionally, the VAS score of back pain significantly reduced from 6.8±0.9 to 1.7±0.8 and the Oswestry Disability Index significantly improved from 59.8±7.5 to 11.6±3.4. No major complications were reported apart from intraoperative dural tear in 2 patients, superficial infection in one patient, deep infection in one patient and temporary paraparesis in one patient. Conclusion: Posterior VCR can provide satisfactory correction in severe PTK and improvement in functional outcome with appropriate application and fine surgical technique. (2018ESJ165)
format	article
author	Ahmed El Naggar, MD., Shamel Elgawhary, MD., Tarek ElHewala, MD.
author_facet	Ahmed El Naggar, MD., Shamel Elgawhary, MD., Tarek ElHewala, MD.
author_sort	Ahmed El Naggar, MD.,
title	Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.
title_short	Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.
title_full	Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.
title_fullStr	Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.
title_full_unstemmed	Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.
title_sort	posterior vertebral column resection in management of severe post-traumatic thoracolumbar kyphosis.
publisher	Egyptian Spine Association
publishDate	2018
url	https://doaj.org/article/4657b9ebbadc44da98ae0854c2b5e36f
work_keys_str_mv	AT ahmedelnaggarmd posteriorvertebralcolumnresectioninmanagementofsevereposttraumaticthoracolumbarkyphosis AT shamelelgawharymd posteriorvertebralcolumnresectioninmanagementofsevereposttraumaticthoracolumbarkyphosis AT tarekelhewalamd posteriorvertebralcolumnresectioninmanagementofsevereposttraumaticthoracolumbarkyphosis
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Posterior Vertebral Column Resection in Management of Severe Post-traumatic Thoracolumbar Kyphosis.

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