Modified closing-opening wedge osteotomy for the treatment of sagittal malalignment in thoracolumbar fractures malunion

Bourghli, Anouar; Boissière, Louis; Vital, Jean-Marc; Bourghli, Mohamed Aiman; Almusrea, Khaled; Khoury, Ghassan; Obeid, Ibrahim

doi:10.1016/j.spinee.2015.08.062

Cited by 19 publications

(14 citation statements)

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“…Recently, modified wedge closing osteotomy has been introduced in the treatment of post-traumatic kyphosis with less complications, satisfactory correction, and good fusion rate. [ 33 – 35 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

Zhi

Hua

et al. 2017

Medicine

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Rationale:Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients’ life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation.Patient concerns:All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently.Diagnoses:A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved.Interventions:Wedge osteotomy was performed as indicated—posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes.Outcomes:All the patients were followed up, with the average period of 38.5 months (range 24–56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%.Lessons:Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture operation can obtain good radiologic and clinical outcomes by kyphosis correction, decompression, and posterior stability.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

Zhi

Hua

et al. 2017

Medicine

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“…The spine kyphosis deformity is mainly caused by congenial, tuberculosis, ankylosing spondylitis, fracture, etc. [1,2,[12][13][14][15][16][17]. The lumbar osteotomies are appropriate surgical techniques to improve the global sagittal balance of the spine, increasing the lumbar lordosis and decreasing the pelvic (lower PT) and the femoral (lower femoral exion) compensation.…”

Section: Discussionmentioning

confidence: 99%

“…Ji et al [11] reported that in case of osteotomy after the treatment of kyphosis, the length of the aorta was increased by 2.2 cm and the diameter of the aorta was decreased by 0.41 cm. Bourghli et al [12] adapted a new surgical method of osteotomy to treat the angular kyphosis caused by fracture, and it was found that after surgery, the length of the aorta was increased by 2.3 cm. The above-mentioned studies indicated that due to elongation of the anterior column, the aorta may be stretched and vulnerable to injuries, especially in the elderly patients with reduced elasticity of the aortic wall.…”

Section: Discussionmentioning

confidence: 99%

“…Since no obvious calci cation was observed in many cases, it therefore was not appropriate for all patients. Ji et al [11] and Bourghli et al [12] measured the length of the aorta between the instrumented vertebrate, and reported the changes in aorta. Although the aorta was xed with aortic hiatus and branch vessel, the position of the aorta shifted with the change of body, indicating that their method is inaccurate.…”

Section: Discussionmentioning

confidence: 99%

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A Novel Computerized Method for Measuring the Length of the Aorta in Patients with Severe Kyphotic Deformity

Liang¹,

Duan²,

Rao³

et al. 2020

Preprint

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Objective: This study aimed to explore a new method for measuring the length of the aorta in patients with severe kyphotic deformity.Methods: The computed tomography (CT) scan data of one patient with severe kyphotic deformity were retrospectively collected. The data were saved as Digital Imaging and Communications in Medicine (DICOM) format, and were imported into MIMICS software for processing. Then, the MASK function of the MIMICS software was used to mark the aorta in each slice of CT, and a three-dimensional (3D) reconstruction model of the aorta was established. After that, the length of the aorta was defined as the length of the centerline, which was calculated by the MIMICS. Besides, two points were fixed as anchor, and the length of aorta was acquired by measuring the distance between the two points. The proximal one was the origin of the left subclavian artery, and the fork was the distal of iliac artery. The length of the aorta was measured preoperatively and postoperatively as well. Results: The 3D reconstruction model of the aorta was successfully established. It was revealed that the length of aorta was 418.9 mm preoperatively, and 435.4 mm postoperatively. The patient also underwent pedicle subtraction osteotomy (PSO). After orthopedic surgery, the length of the aorta was stretched by 16.5 mm. Conclusion: In the present research, a 3D reconstruction model of the aorta was successfully established, and the length of the aorta was accurately measured without any invasive procedure. Using MIMICS software, the length of aorta in patients with severe kyphotic deformity could be effectively and precisely measured.

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“…Интраоперационная кровопо-теря считается одним из критериев травматичности операции, ее превы-шение 55 % объема циркулирующей крови обусловливает увеличение пос-леоперационных осложнений [5]. При корригирующих вертебротомиях она составляет в среднем 1570-1600 мл [5,8,26]. В наших случаях кровопотеря была в 2 раза меньше.…”

Section: Discussionunclassified

Staged Surgical Treatment of Posttraumatic Deformities in the Thoracic and Lumbar Spine

Рерих¹,

Borzykh²

2016

Hir. pozvonoč.

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Несмотря на успехи в хирургии повреждений грудного и пояснич-ного отделов позвоночника, вопрос поздних последствий травм грудных и поясничных позвонков остается актуальным. К причинам возникно-вения посттравматических деформа-ций относят неадекватно применен-ный метод консервативного лечения, позднее выявление переломов позво-ночника вследствие тяжести политрав-мы, сочетанной травмы, недиагности-рованные и нелеченные переломы позвонков [17,24].Посттравматические деформации приводят к нарушению сагиттального баланса туловища и возникновению болевых синдромов, функциональной несостоятельности грудного, пояснич-ного отделов позвоночника и космети-чески неприемлемых деформаций [18].

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Modified closing-opening wedge osteotomy for the treatment of sagittal malalignment in thoracolumbar fractures malunion

Cited by 19 publications

References 20 publications

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

A Novel Computerized Method for Measuring the Length of the Aorta in Patients with Severe Kyphotic Deformity

Staged Surgical Treatment of Posttraumatic Deformities in the Thoracic and Lumbar Spine

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