Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance

Background Data: Restoration of sagittal balance typically involves Smith Peterson osteotomy (SPO) or pedicle subtraction osteotomy (PSO). Since 2008, PSO was used for patients with kyphosis at our centers. Purpose: The aim of this study is to report the results of PSO for correcting fixed sagittal...

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Autores principales:	Mohammad El-Sharkawi, Essam El-Sherif, Wael Koptan, Yasser ElMiligui
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2012
Materias:	Sagittal Imbalance kyphosis PSO SPO Ponte Osteotomy Pseudarthrosis Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/fb2b41b9743448209b3b83303e3b25e7
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spelling	oai:doaj.org-article:fb2b41b9743448209b3b83303e3b25e72021-12-02T11:31:37ZPedicle Subtraction Osteotomies for Correcting Sagittal ImbalanceDOI:10.21608/ESJ.2012.37822314-89502314-8969https://doaj.org/article/fb2b41b9743448209b3b83303e3b25e72012-04-01T00:00:00Zhttp://esj.journals.ekb.eg/article_3782.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Restoration of sagittal balance typically involves Smith Peterson osteotomy (SPO) or pedicle subtraction osteotomy (PSO). Since 2008, PSO was used for patients with kyphosis at our centers. Purpose: The aim of this study is to report the results of PSO for correcting fixed sagittal imbalance at a minimum follow up of 24 months. Study Design: Prospective descriptive study. Methods: Twenty four consecutive patients with sagittal imbalance (9 females/15 males), with a mean age at surgery of 33.4 years, were treated with 25 PSOs and prospectively followed for a mean of 36 months. The etiology for imbalance was posttraumatic (n=9), Scheuermann disease (n=6), congenital (n=5), Post-tuberculous (n=3), and post-laminectomy (n=1). PSO was performed at T7 (n=1), T8 (n=1), T9 (n=2), T10 (n=1), T11 (n=3), T12 (n=4), and at L1 (n=6), L2 (n=5), and at L3 (n=2). Radiographic and clinical outcomes analysis was performed. Results: The mean operative time was 5.6±3.2 hours and the mean blood loss was 1,319±1,416 ml. Patients reported very good satisfaction (86%) and good function (79%) at final follow-up. The mean correction of the kyphotic angle at the osteotomy site was 32.3°±5.0°. No permanent neurological deficits were encountered. Postoperative complications included pulling out of screws (n=1) and recurrence of deformity within 48 hours after surgery requiring revision and longer fixation, transient lower limb paraesthesia (n=2), superficial infection (n=1), and significant wound hematoma requiring drainage (n=2). Progressive distal junctional kyphosis occurring in a patient with Scheuermann’s disease was managed 6 months later with vertebral column resection and distal fixation. One patient developed pseudarthrosis and implant failure 9 months postoperatively. He was revised by graft augmentation and rods exchange. Conclusion: PSO can provide satisfactory clinical and radiographic outcomes with acceptable risk and morbidity. (2012ESJ016) Mohammad El-Sharkawi Essam El-SherifWael Koptan Yasser ElMiliguiEgyptian Spine AssociationarticleSagittal ImbalancekyphosisPSOSPOPonte OsteotomyPseudarthrosisNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 2, Iss 1, Pp 20-29 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sagittal Imbalance kyphosis PSO SPO Ponte Osteotomy Pseudarthrosis Neurology. Diseases of the nervous system RC346-429
spellingShingle	Sagittal Imbalance kyphosis PSO SPO Ponte Osteotomy Pseudarthrosis Neurology. Diseases of the nervous system RC346-429 Mohammad El-Sharkawi Essam El-Sherif Wael Koptan Yasser ElMiligui Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
description	Background Data: Restoration of sagittal balance typically involves Smith Peterson osteotomy (SPO) or pedicle subtraction osteotomy (PSO). Since 2008, PSO was used for patients with kyphosis at our centers. Purpose: The aim of this study is to report the results of PSO for correcting fixed sagittal imbalance at a minimum follow up of 24 months. Study Design: Prospective descriptive study. Methods: Twenty four consecutive patients with sagittal imbalance (9 females/15 males), with a mean age at surgery of 33.4 years, were treated with 25 PSOs and prospectively followed for a mean of 36 months. The etiology for imbalance was posttraumatic (n=9), Scheuermann disease (n=6), congenital (n=5), Post-tuberculous (n=3), and post-laminectomy (n=1). PSO was performed at T7 (n=1), T8 (n=1), T9 (n=2), T10 (n=1), T11 (n=3), T12 (n=4), and at L1 (n=6), L2 (n=5), and at L3 (n=2). Radiographic and clinical outcomes analysis was performed. Results: The mean operative time was 5.6±3.2 hours and the mean blood loss was 1,319±1,416 ml. Patients reported very good satisfaction (86%) and good function (79%) at final follow-up. The mean correction of the kyphotic angle at the osteotomy site was 32.3°±5.0°. No permanent neurological deficits were encountered. Postoperative complications included pulling out of screws (n=1) and recurrence of deformity within 48 hours after surgery requiring revision and longer fixation, transient lower limb paraesthesia (n=2), superficial infection (n=1), and significant wound hematoma requiring drainage (n=2). Progressive distal junctional kyphosis occurring in a patient with Scheuermann’s disease was managed 6 months later with vertebral column resection and distal fixation. One patient developed pseudarthrosis and implant failure 9 months postoperatively. He was revised by graft augmentation and rods exchange. Conclusion: PSO can provide satisfactory clinical and radiographic outcomes with acceptable risk and morbidity. (2012ESJ016)
format	article
author	Mohammad El-Sharkawi Essam El-Sherif Wael Koptan Yasser ElMiligui
author_facet	Mohammad El-Sharkawi Essam El-Sherif Wael Koptan Yasser ElMiligui
author_sort	Mohammad El-Sharkawi
title	Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
title_short	Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
title_full	Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
title_fullStr	Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
title_full_unstemmed	Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance
title_sort	pedicle subtraction osteotomies for correcting sagittal imbalance
publisher	Egyptian Spine Association
publishDate	2012
url	https://doaj.org/article/fb2b41b9743448209b3b83303e3b25e7
work_keys_str_mv	AT mohammadelsharkawi pediclesubtractionosteotomiesforcorrectingsagittalimbalance AT essamelsherif pediclesubtractionosteotomiesforcorrectingsagittalimbalance AT waelkoptan pediclesubtractionosteotomiesforcorrectingsagittalimbalance AT yasserelmiligui pediclesubtractionosteotomiesforcorrectingsagittalimbalance
_version_	1718395917303808000

Pedicle Subtraction Osteotomies for Correcting Sagittal Imbalance

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