Spinal Osteotomy: Correcting Sagittal Balance in Tuberculous Spondylitis

Gökçe, Alper; Öztürkmen, Yusuf; Mutlu, Savas; Caniklioglu, Mustafa

doi:10.1097/bsd.0b013e3181586023

Cited by 25 publications

(19 citation statements)

References 24 publications

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“…An average kyphosis of 56°was reduced to 30°at the latest follow-up. The one-stage procedure described previously carries a risk of neurologic injury when the patient's position is changed for the posterior approach, as anterior debridement without immediate structure graft causes spinal instability [24,25]. Jain et al [20] proposed an anterolateral extrapleural approach to complete the anterior debridement, posterior fixation, and anterior grafting procedure in one incision.…”

Section: Discussionmentioning

confidence: 99%

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Single-stage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity

Wang

et al. 2011

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

“…Other surgeons attempted to address this challenge with single-stage posterior debridement and fixation [15,16,24]. This strategy can only be used with localized foci of no more than three levels and without extensive formation of abscesses.…”

Section: Discussionmentioning

confidence: 99%

Single-stage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity

Wang

et al. 2011

International Orthopaedics (SICOT)

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“…These authors have used segmental spinal instrumentation with pedicle screws and rods. In most of these reports, additional procedures such as posterior closing wedge osteotomy, and posterior inter-body fusion using bone grafts with or without cages have been performed [37,[39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Kumar¹,

Joseph²,

Manur³

2012

Eur Spine J

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Purpose The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoracolumbar spinal tuberculosis treated with isolated posterior instrumentation without any posterior bone grafting or anterior inter-body bone grafting or anterior instrumentation. Methods The study was a prospective follow-up of 25 patients with active thoraco-lumbar spinal tuberculosis who underwent posterior spinal instrumentation with pedicle screws and rods. These patients had posterior stabilization of the involved segment of the spine without anterior or posterior bone grafting. The mean duration of follow-up was 3.3 years and the minimum duration of follow-up was 2 years. Results The mean kyphotic angle improved from 32.4°p re-operatively to 7.2°in the early follow-up period. Following a minor loss of correction during follow-up, the mean kyphotic angle settled at 11.5°at the time of final follow-up. Inter-body bony fusion was noticed at the final follow-up in all patients despite the absence of anterior bone grafting or cages. Conclusion Posterior instrumented stabilization followed by chemotherapy seems to be adequate for obtaining satisfactory healing of the lesions. Anterior inter-body bony arthrodesis occurs despite the absence of anterior bone grafts or cages. Careful patient selection is critical for successful outcome with this technique.

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“…d Lateral radiograph shows anterior cage support with bone graft and posterior instrumented fusion. e Clinical appearance postoperatively deformity correction (kyphosis reduction to under 50% of the preoperative magnitude) and high fusion rates with pedicle subtraction osteotomy [29,30].…”

Section: Osteotomies and Vertebral Column Resectionmentioning

confidence: 99%

“…Anterior debridement may be followed by anterior reconstruction with bone graft and either anterior or posterior instrumentation [2,7,12,13,[15][16][17][18][19][20][21][22][23]. For larger degrees of kyphotic deformity (greater than 80 degrees of kyphosis) and stiffer curves (less than 25% flexibility), several types of osteotomies may be helpful in increasing curve flexibility [24][25][26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Overview Of Surgical Treatmentmentioning

confidence: 99%

Surgical correction of kyphotic deformity in spinal tuberculosis

Issack

Boachie-Adjei

2011

International Orthopaedics (SICOT)

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Purpose Approximately 5% of patients with spinal tuberculosis will develop a severe kyphotic deformity resulting in increased potential for pain, spinal cord compression, cardiopulmonary dysfunction, costopelvic impingement and cosmetic concerns. This manuscript reviews the evaluation and surgical management of tuberculous kyphosis. Methods This is a review article. Results Risk factors for the development of severe kyphosis include those who develop spinal tuberculosis as children, multiple vertebral body involvement and thoracic spine involvement. These complications can be prevented by early diagnosis and treatment of spinal tubercular lesions at stages with little to no deformity. When tubercular lesions result in progression of kyphosis to more than 50 degrees, the deformity should be surgically corrected to avoid problems associated with sagittal imbalance. There are several operations described for the treatment of kyphosis secondary to tuberculous spondylitis. The type of the operation depends on the magnitude of correction required. Conclusions Anterior, posterior and combined techniques as well as osteotomies and vertebral column resection have been described to correct spinal alignment and restore sagittal balance.

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Spinal Osteotomy: Correcting Sagittal Balance in Tuberculous Spondylitis

Abstract: Despite developing pseudarthrosis secondary to implant failure in 1 case, we recommend debridement, closing wedge osteotomy, and posterior instrumented fusion to correct sagittal balance in tuberculous spondylitis.

Cited by 25 publications

References 24 publications

Single-stage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity

Single-stage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Surgical correction of kyphotic deformity in spinal tuberculosis

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