Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis

Background Data: Late Post-traumatic thoracolumbar kyphosis can occur in a proportion of thoracolumbar fractures after inappropriate treatment. There are several surgical options to correct late post-traumatic thoracolumbar kyphosis, including anterior, posterior, and combined approaches, which are...

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Autores principales: Tariq Awad, Salem Faisel
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Publicado: Egyptian Spine Association 2017
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spelling oai:doaj.org-article:5f0c7070eb7d46b48f905c66c1dd516a2021-12-02T07:50:53ZPedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosisDOI:10.21608/ESJ.2017.71382314-89502314-8969https://doaj.org/article/5f0c7070eb7d46b48f905c66c1dd516a2017-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_7138.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Late Post-traumatic thoracolumbar kyphosis can occur in a proportion of thoracolumbar fractures after inappropriate treatment. There are several surgical options to correct late post-traumatic thoracolumbar kyphosis, including anterior, posterior, and combined approaches, which are associated with varying degrees of clinical and radiological outcome success. Purpose: The aim of this study was to assess the use of a pedicle disc wedge osteotomy for the treatment of late post-traumatic thoracolumbar kyphosis and to evaluate the radiographic findings and clinical outcomes of patients treated by this technique. Study Design: A descriptive retrospective clinical case study. Patients and Methods: Ten consecutive patients with symptomatic post-traumatic thoracolumbar kyphosis were treated using a pedicle disc wedge osteotomy. The mean patient age was 37.5 years. The initial trauma in all patients was Type A3, A4 according to AOSPINE thoracolumbar trauma classification. The kyphosis apex ranged from T-12 to L-2. The sagittal alignment, kyphotic angle, neurological function, Visual Analog Scale for back pain, and Oswestry Disability Index were evaluated before surgery and at follow-up. Results: The mean preoperative regional angle was 35.5°, and the mean correction angle was 28.5°. Sagittal alignment improved with a mean correction rate of 47%. The mean surgical time was 227 minutes, and the mean intraoperative blood loss was 1380 ml. The mean Visual Analog Score for back pain improved from 8.2 to 2.0, and the Oswestry Disability Index score decreased from 56.4 to 24.4 at the last follow-up. All patients achieved bony fusion based on the presence of trabecular bone bridging at the osteotomy site. Conclusion: The pedicle disc wedge osteotomy technique achieves satisfactory kyphosis correction with direct visualization of the circumferentially decompressed spinal cord, as well as good fusion. (2017ESJ139) Tariq AwadSalem FaiselEgyptian Spine AssociationarticleThoracolumbar fractureposttraumatic thoracolumbar kyphosispedicle disc wedge osteotomydeformityNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 24, Iss 1, Pp 34-41 (2017)
institution DOAJ
collection DOAJ
language EN
topic Thoracolumbar fracture
posttraumatic thoracolumbar kyphosis
pedicle disc wedge osteotomy
deformity
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Thoracolumbar fracture
posttraumatic thoracolumbar kyphosis
pedicle disc wedge osteotomy
deformity
Neurology. Diseases of the nervous system
RC346-429
Tariq Awad
Salem Faisel
Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis
description Background Data: Late Post-traumatic thoracolumbar kyphosis can occur in a proportion of thoracolumbar fractures after inappropriate treatment. There are several surgical options to correct late post-traumatic thoracolumbar kyphosis, including anterior, posterior, and combined approaches, which are associated with varying degrees of clinical and radiological outcome success. Purpose: The aim of this study was to assess the use of a pedicle disc wedge osteotomy for the treatment of late post-traumatic thoracolumbar kyphosis and to evaluate the radiographic findings and clinical outcomes of patients treated by this technique. Study Design: A descriptive retrospective clinical case study. Patients and Methods: Ten consecutive patients with symptomatic post-traumatic thoracolumbar kyphosis were treated using a pedicle disc wedge osteotomy. The mean patient age was 37.5 years. The initial trauma in all patients was Type A3, A4 according to AOSPINE thoracolumbar trauma classification. The kyphosis apex ranged from T-12 to L-2. The sagittal alignment, kyphotic angle, neurological function, Visual Analog Scale for back pain, and Oswestry Disability Index were evaluated before surgery and at follow-up. Results: The mean preoperative regional angle was 35.5°, and the mean correction angle was 28.5°. Sagittal alignment improved with a mean correction rate of 47%. The mean surgical time was 227 minutes, and the mean intraoperative blood loss was 1380 ml. The mean Visual Analog Score for back pain improved from 8.2 to 2.0, and the Oswestry Disability Index score decreased from 56.4 to 24.4 at the last follow-up. All patients achieved bony fusion based on the presence of trabecular bone bridging at the osteotomy site. Conclusion: The pedicle disc wedge osteotomy technique achieves satisfactory kyphosis correction with direct visualization of the circumferentially decompressed spinal cord, as well as good fusion. (2017ESJ139)
format article
author Tariq Awad
Salem Faisel
author_facet Tariq Awad
Salem Faisel
author_sort Tariq Awad
title Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis
title_short Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis
title_full Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis
title_fullStr Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis
title_full_unstemmed Pedicle Disc Wedge Osteotomy for the Correction of Late Post-traumatic Thoracolumbar kyphosis
title_sort pedicle disc wedge osteotomy for the correction of late post-traumatic thoracolumbar kyphosis
publisher Egyptian Spine Association
publishDate 2017
url https://doaj.org/article/5f0c7070eb7d46b48f905c66c1dd516a
work_keys_str_mv AT tariqawad pediclediscwedgeosteotomyforthecorrectionoflateposttraumaticthoracolumbarkyphosis
AT salemfaisel pediclediscwedgeosteotomyforthecorrectionoflateposttraumaticthoracolumbarkyphosis
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