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Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine
BACKGROUND: In patients with cervical ankylosis, the chin-brow vertical angle (CBVA) should be taken into consideration. Usually, the correction of sagittal balance is sacrificed to ensure the patient has a horizontal visual field. To our knowledge, a staged osteotomy strategy for ankylosing spondyl...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480419/ https://www.ncbi.nlm.nih.gov/pubmed/31014379 http://dx.doi.org/10.1186/s13018-019-1146-5 |
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author | Wang, Tianhao Song, Diyu Zheng, Guoquan Wang, Yan |
author_facet | Wang, Tianhao Song, Diyu Zheng, Guoquan Wang, Yan |
author_sort | Wang, Tianhao |
collection | PubMed |
description | BACKGROUND: In patients with cervical ankylosis, the chin-brow vertical angle (CBVA) should be taken into consideration. Usually, the correction of sagittal balance is sacrificed to ensure the patient has a horizontal visual field. To our knowledge, a staged osteotomy strategy for ankylosing spondylitis kyphotic deformity with an ankylosed cervical spine has not been reported before. The aim of this study was to describe a new surgical strategy with emphasis on sagittal balance and gaze angle in correction of kyphotic deformity with a rigid cervical spine in ankylosing spondylitis thoracolumbar kyphotic deformity. METHODS: A 36-year-old man has severe thoracolumbar kyphosis accompanied with cervical hyperlordosis caused by ankylosing spondylitis. A two-stage surgery planning was managed. For the first stage, an interrupted two-level osteotomy was performed at the thoracolumbar area. After surgery, sagittal imbalance was corrected but the CBVA was − 21.7°. Cervical osteotomy was performed for the second stage. A flexion osteotomy was performed at C7, using anterior-posterior-anterior approaches. RESULTS: Both sagittal imbalance and gaze angle of the patient were improved markedly. The osteotomy sites were documented fused. Complications were not observed during and after operation. CONCLUSIONS: The aim of osteotomy for ankylosing spondylitis is to reestablish sagittal balance and improve forward gaze and the visual field. A staged cervical osteotomy is an alternative to reduce cervical lordosis to obtain a normal gaze angle. An anterior-posterior-anterior approach is recommended. |
format | Online Article Text |
id | pubmed-6480419 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64804192019-05-01 Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine Wang, Tianhao Song, Diyu Zheng, Guoquan Wang, Yan J Orthop Surg Res Research Article BACKGROUND: In patients with cervical ankylosis, the chin-brow vertical angle (CBVA) should be taken into consideration. Usually, the correction of sagittal balance is sacrificed to ensure the patient has a horizontal visual field. To our knowledge, a staged osteotomy strategy for ankylosing spondylitis kyphotic deformity with an ankylosed cervical spine has not been reported before. The aim of this study was to describe a new surgical strategy with emphasis on sagittal balance and gaze angle in correction of kyphotic deformity with a rigid cervical spine in ankylosing spondylitis thoracolumbar kyphotic deformity. METHODS: A 36-year-old man has severe thoracolumbar kyphosis accompanied with cervical hyperlordosis caused by ankylosing spondylitis. A two-stage surgery planning was managed. For the first stage, an interrupted two-level osteotomy was performed at the thoracolumbar area. After surgery, sagittal imbalance was corrected but the CBVA was − 21.7°. Cervical osteotomy was performed for the second stage. A flexion osteotomy was performed at C7, using anterior-posterior-anterior approaches. RESULTS: Both sagittal imbalance and gaze angle of the patient were improved markedly. The osteotomy sites were documented fused. Complications were not observed during and after operation. CONCLUSIONS: The aim of osteotomy for ankylosing spondylitis is to reestablish sagittal balance and improve forward gaze and the visual field. A staged cervical osteotomy is an alternative to reduce cervical lordosis to obtain a normal gaze angle. An anterior-posterior-anterior approach is recommended. BioMed Central 2019-04-23 /pmc/articles/PMC6480419/ /pubmed/31014379 http://dx.doi.org/10.1186/s13018-019-1146-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Wang, Tianhao Song, Diyu Zheng, Guoquan Wang, Yan Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
title | Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
title_full | Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
title_fullStr | Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
title_full_unstemmed | Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
title_short | Staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
title_sort | staged cervical osteotomy:a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480419/ https://www.ncbi.nlm.nih.gov/pubmed/31014379 http://dx.doi.org/10.1186/s13018-019-1146-5 |
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