Multisegmental Osteotomy for Kyphotic Deformity in Ankylosing Spondylitis

Chung, Jae Yoon; Chung, Go Hun; Park, Ki Sang

doi:10.4055/jkoa.1996.31.3.455

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“…After osteotomy, Harrington compression rods, Zielke instrumentation, Luque wire or C-D can be used, each with advantages and disadvantages. In our country, Chung et al 22 reported 5 cases of multiple segment osteotomy. We performed the Thomasen technique in 8 cases, obtaining excellent correction ( Fig.…”

Section: Discussionmentioning

confidence: 82%

Surgical Correction of Fixed Kyphosis

et al. 2007

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Study DesignA retrospective review was carried out on 23 patients with rigid fixed kyphosis who underwent surgical correction for their deformity.PurposeTo report the results of surgical correction of fixed kyphosis according to the surgical approaches or methods.Overview of LiteratureSurgical correction of fixed kyphosis is more dangerous than the correction of any other spinal deformity because of the high incidence of paraplegia.MethodsThere were 12 cases of acute angular kyphosis (6 congenital, 6 healed tuberculosis) and 11 cases of round kyphosis (10 ankylosing spondylitis, 1 Scheuermann's kyphosis). Patients were excluded if their kyphosis was due to active tuberculosis, fractures, or degenerative lumbar changes. Operative procedures consisted of anterior, posterior and combined approaches with or without total vertebrectomy. Anterior procedure only was performed in 2 cases, while posterior procedure only was performed in 8 cases. Combined procedures were used in 13 cases, including 4 total vertebrectomies.ResultsThe average kyphotic angle was 71.8° preoperatively, 31.0° postoperatively, and the average final angle was 39.2°. Thus, the correction rate was 57% and the correction loss rate was 12%. In acute angular kyphosis, correction rate of an anterior procedure only was 71%, correction rate of the combined procedures without total vertebrectomy was 49% and correction rate of the combined procedures with total vertebrectomy was 60%. In round kyphosis, correction rate of posterior procedure only was 65% and correction rate of combined procedures was 59%. The clinical results according to the Kirkaldy-Willis scale demonstrated 17 excellent outcomes, 5 good outcomes and one poor outcome.ConclusionsOur data indicates that the combined approach and especially the total vertebrectomy showed the safety and the greatest correction rate if acute angular kyphosis was greater than 60 degrees.

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Section: Discussionmentioning

confidence: 82%