Multiple Segmental Osteotomies to the Kyphosis Correction

Herrero, Carlos Fernando Pereira da Silva; Porto, Maximiliano Aguiar; Barbosa, Marcello Henrique Nogueira; Defino, Helton Luíz Aparecido

doi:10.1016/s2255-4971(15)30150-6

Cited by 2 publications

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References 26 publications

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“…Likewise, only two studies [ 16 , 18 ] compared postoperative PJK incidence between AP and PO cohorts, and pooled analysis of PJK incidence showed no difference, as shown in Figure 5 . Four studies [ 4 , 5 , 15 , 18 ] have reported incidence of distal junctional kyphosis (DJK), but no studies compared the incidence of postoperative DJK between AP and PO cohorts. The PJK incidence was reported to range from 0% to 31%.…”

Section: Resultsmentioning

confidence: 99%

Surgical Procedures Used for Correction of Scheuermann’s Kyphosis: A Meta-Analysis

Liu

2021

Pain Research and Management

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Objectives. Scheuermann’s kyphosis can cause severe back pain and cosmetic disorders to patients. Previous studies on surgical procedure selection for correction of Scheuermann’s kyphosis have drawn controversial conclusions. Here, a meta-analysis was performed to figure out a better way between anterior-posterior (AP) combined procedures and posterior-only (PO) procedures. Methods. We searched PubMed database and Ovid database, as well as Cochrane Library (between January 2009 and December 2020, around recent ten years), for studies reporting Scheuermann’s kyphosis correction in an anterior way or a posterior way. Random effects meta-analysis regarding correction degrees and incidence of proximal junctional kyphosis (PJK) was performed. Results. Finally, 13 unique studies including 586 patients (AP: 300; PO: 286) were identified and included for this meta-analysis. Overall, 6 AP cohorts and 10 PO cohorts were pooled regarding the correction degrees of kyphosis in the analysis, respectively. Pooled correction degrees in AP cohorts were 33.31 (95% CI: 27.48–39.15; I2 = 86%, P < 0.001 ) and in PO cohorts were 31.16 (95% CI: 26.97–35.35; I2 = 81.1%, P < 0.001 ). Comparison of correction between AP and PO cohorts did not indicate any significant difference. Likewise, postoperative PJK incidence showed no difference. Back pain can be caused by both AP and PO procedures, but which causes less pain remains to be conclusive. The PO approach showed less blood loss and shorter surgical duration as compared to the AP approach. Conclusions. In summary, this meta-analysis shows similar treatment effects between AP and PO procedures in correcting Scheuermann’s kyphosis, suggesting the advantage of PO procedures due to less blood loss and surgical duration. However, the postoperative complications PJK and distal junctional kyphosis (DJK) cannot be well concluded due to the limitation of existing data.

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Section: Resultsmentioning

confidence: 99%

Surgical Procedures Used for Correction of Scheuermann’s Kyphosis: A Meta-Analysis

Liu

2021

Pain Research and Management

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“…As loss of correction was small and clinical outcome was satisfactory, the authors decided not to perform a second surgical approach. After this case, the group's conduct was modified and the definition of distal fixation levels was made including the first level in lordosis, as recommended in the treatment of Scheuermann's kyphosis 20 . In the second case, there was an L4 fracture with significant impact on sagittal balance and functional outcome, but patient was not reoperated due to clinical contraindication (case 11, Fig.…”

Section: Discussionmentioning

confidence: 99%

Posterior three-column osteotomies for the treatment of rigid thoracic kyphosis – a case series

Simões

Abreu

Winkler

2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the results and complications of a series of patients who underwent three-column osteotomy using the posterior approach for correction of complex cases of rigid dorsal kyphotic deformity.MethodsReview of clinical records and images of 15 consecutive cases of pedicle subtraction osteotomies, bone-disk-bone osteotomies, or vertebral column resection, recording the etiology, type and level of osteotomy, extension of fixation, complications, and pre- and post-surgical measurements of the sagittal curves and pelvic parameters.ResultsSix pedicle subtraction osteotomies were performed, one of which in two adjacent vertebrae, as well as two bone-disk-bone osteotomies and seven vertebral column resection, two of which were performed in two adjacent vertebrae. The mean correction was 39.3° for the angular kyphosis and 33.9° for dorsal kyphosis. The corrections were similar regardless of the kind of osteotomy, the operated spinal segment, or the approach in one or two levels, but this may be a sample effect.Eight complications were observed in six patients (40% of cases): two medical complications, five early and one late surgical complication (over 90 days after surgery). There were three reoperations within less than one year from the initial surgery and one case of persistent paraparesis. Clinical complications were resolved without sequelae. There was no significant loss of correction during the segment, except in two cases of major mechanical failure due to a junctional segment fracture.ConclusionDespite being complex and aggressive procedures, prone to various complications, osteotomies with resection of the three columns are highly effective in the correction of rigid kyphotic deformities and safe enough to justify its use in selected cases.

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Multiple Segmental Osteotomies to the Kyphosis Correction

Cited by 2 publications

References 26 publications

Surgical Procedures Used for Correction of Scheuermann’s Kyphosis: A Meta-Analysis

Surgical Procedures Used for Correction of Scheuermann’s Kyphosis: A Meta-Analysis

Posterior three-column osteotomies for the treatment of rigid thoracic kyphosis – a case series

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