A Safe Controlled Instrumented Reduction Technique for Cervical Osteotomy in Ankylosing Spondylitis

Abstract

This innovative new technique provides for a safe, controlled reduction for cervical osteotomy for fixed cervicothoracic kyphosis in AS. The technique reliably renders rigid immobilization that obviates the risk of intra- and postoperative junctional subluxation, eliminates the need for postoperative halo-vest immobilization, and achieves satisfactory fusion.

Non-instrumented correction of cervicothoracic kyphosis in ankylosing spondylitis: a critical analysis on the results of open-wedge osteotomy C7-T1 with gradual Halo-Thoracic-Cast based correction

“…However, there is an increasing interest in the outcome of surgical CTK correction because of evolving techniques [4,5]. CTK can cause significant disability due to loss of horizontal gaze, functional limitation, chin-on-chest deformity with swallowing difficulties, neck pain, weakness due to the spinal cord stretched over the apex or neuroforamina stenosis, and increases the risk of fall-related injuries [4][5][6][7][8][9]. Surgery yields to restore horizontal gaze, sagittal balance, improve function, diminish social disability and provides durable correction [4,5,[9][10][11][12][13].…”

“…Clinical series serving evidence to outline the most efficient surgical correction procedure are lacking. Until now surgery poses high neurologic risks [4,5,7,[14][15][16].…”

Chirurgie du rachis et spondylarthrite

“…Simmons [35] l'a réalisée initialement sous anesthésie locale, en position assise maintenue par étrier ou halo. Actuellement, elle est réalisée en position allongée, la tête maintenue par un étrier et redressée, une fois l'ostéotomie réa-lisée avec stabilisation par une ostéosynthèse postérieure longue [36,37].…”

A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction

“…27,32,35,50,51,61 Several series of patients with cervical deformity treated with a Grade 5 osteotomy have been reported. 1,11,32,34,35,50,51 Grade 6: Closing Wedge Osteotomy A Grade 6 osteotomy involves complete removal of the posterior elements, including the lamina, spinous process, and facets, followed by removal of the pedicles and creation of a closing wedge in the vertebral body (Fig. 7).…”

“…Primary among these is the development of an agreed-upon nomenclature in this process to allow direct outcome comparisons among clearly defined techniques. The primary techniques for correction of rigid CSDs are osteotomies, 1,3,7,9,12,14,20,31,32,34,35,39,40,51,56,59,61,62 which have many variations and lack a standardized nomenclature. As a first step toward the long-term goal of developing a cervical deformity classification system, our objective in the present study was to establish a standardized nomenclature for cervical spine osteotomies to provide a common language among spine surgeons.…”