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Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients

OBJECTIVE: To evaluate the sagittal parameters and clinical outcome of pedicle subtraction osteotomy (PSO) for the treatment of ankylosing spondylitis (AS) combined with thoracolumbar kyphosis. METHODS: The clinical data of 38 patients with AS combined with thoracolumbar kyphosis who underwent PSO w...

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Autores principales: Luan, Haopeng, Liu, Kai, Kahaer, Alafate, Wang, Yao, Sheng, Weibin, Maimaiti, Maierdan, Guo, Hailong, Deng, Qiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338567/
https://www.ncbi.nlm.nih.gov/pubmed/35907844
http://dx.doi.org/10.1186/s12891-022-05693-z
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author Luan, Haopeng
Liu, Kai
Kahaer, Alafate
Wang, Yao
Sheng, Weibin
Maimaiti, Maierdan
Guo, Hailong
Deng, Qiang
author_facet Luan, Haopeng
Liu, Kai
Kahaer, Alafate
Wang, Yao
Sheng, Weibin
Maimaiti, Maierdan
Guo, Hailong
Deng, Qiang
author_sort Luan, Haopeng
collection PubMed
description OBJECTIVE: To evaluate the sagittal parameters and clinical outcome of pedicle subtraction osteotomy (PSO) for the treatment of ankylosing spondylitis (AS) combined with thoracolumbar kyphosis. METHODS: The clinical data of 38 patients with AS combined with thoracolumbar kyphosis who underwent PSO were enrolled and divided into the lumbar lordosis group and the lumbar kyphosis group according to the preoperative sagittal morphology. They were subdivided into the lumbar lordosis T12 group, lordosis L1 group, kyphosis L2 group, and kyphosis L3 group. The spine sagittal parameters were compared between the preoperative and the postoperative. Outcome evaluation was performed by the Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS), and the Oswestry Disability Index (ODI). RESULTS: A total of 38 patients with AS combined with thoracolumbar kyphosis were successfully treated by PSO, with a mean follow-up time of 26.9 ± 11.9 months. There were 30 males and 8 females with a mean age of 41.6 ± 7.1 years. Twenty patients consisted in the lumbar lordosis group and 18 patients in the lumbar kyphosis group. GK, SVA, and CBVA were improved significantly (P < 0.05) at the final follow-up between the lumbar lordosis T12 group and the L1 group. Patients in the lumbar kyphosis L2 group and L3 group all received satisfactory, including LL, GK, and SVA (P < 0.05). There was no statistically significant difference in the preoperative TK, GK, SVA, PT, and PI between the lumbar lordosis and lumbar kyphosis groups (P > 0.05). Postoperative complications occurred in three cases. CONCLUSION: PSO was a practical method for the treatment of patients with AS combined with thoracolumbar kyphosis. PSO at L3 was recommended to be selected for the lumbar kyphosis to obtain greater SVA correction. CBVA of single-segment PSO may be significantly lower than the two-segment PSO in the management of patients with kyphosis of lower CBVA.
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spelling pubmed-93385672022-07-31 Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients Luan, Haopeng Liu, Kai Kahaer, Alafate Wang, Yao Sheng, Weibin Maimaiti, Maierdan Guo, Hailong Deng, Qiang BMC Musculoskelet Disord Research OBJECTIVE: To evaluate the sagittal parameters and clinical outcome of pedicle subtraction osteotomy (PSO) for the treatment of ankylosing spondylitis (AS) combined with thoracolumbar kyphosis. METHODS: The clinical data of 38 patients with AS combined with thoracolumbar kyphosis who underwent PSO were enrolled and divided into the lumbar lordosis group and the lumbar kyphosis group according to the preoperative sagittal morphology. They were subdivided into the lumbar lordosis T12 group, lordosis L1 group, kyphosis L2 group, and kyphosis L3 group. The spine sagittal parameters were compared between the preoperative and the postoperative. Outcome evaluation was performed by the Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS), and the Oswestry Disability Index (ODI). RESULTS: A total of 38 patients with AS combined with thoracolumbar kyphosis were successfully treated by PSO, with a mean follow-up time of 26.9 ± 11.9 months. There were 30 males and 8 females with a mean age of 41.6 ± 7.1 years. Twenty patients consisted in the lumbar lordosis group and 18 patients in the lumbar kyphosis group. GK, SVA, and CBVA were improved significantly (P < 0.05) at the final follow-up between the lumbar lordosis T12 group and the L1 group. Patients in the lumbar kyphosis L2 group and L3 group all received satisfactory, including LL, GK, and SVA (P < 0.05). There was no statistically significant difference in the preoperative TK, GK, SVA, PT, and PI between the lumbar lordosis and lumbar kyphosis groups (P > 0.05). Postoperative complications occurred in three cases. CONCLUSION: PSO was a practical method for the treatment of patients with AS combined with thoracolumbar kyphosis. PSO at L3 was recommended to be selected for the lumbar kyphosis to obtain greater SVA correction. CBVA of single-segment PSO may be significantly lower than the two-segment PSO in the management of patients with kyphosis of lower CBVA. BioMed Central 2022-07-30 /pmc/articles/PMC9338567/ /pubmed/35907844 http://dx.doi.org/10.1186/s12891-022-05693-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Luan, Haopeng
Liu, Kai
Kahaer, Alafate
Wang, Yao
Sheng, Weibin
Maimaiti, Maierdan
Guo, Hailong
Deng, Qiang
Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
title Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
title_full Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
title_fullStr Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
title_full_unstemmed Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
title_short Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
title_sort pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338567/
https://www.ncbi.nlm.nih.gov/pubmed/35907844
http://dx.doi.org/10.1186/s12891-022-05693-z
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