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Improvements seen for patients with ankylosing spondylitis kyphosis after spinal osteotomy
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PHILADELPHIA — According to a presenter at the Scoliosis Research Society Annual Meeting, spinal osteotomy may improve quality of life for patients with ankylosing spondylitis kyphosis.
“From our series of clinical research, we had to know what is the sagittal decision-making for these kinds of patients, the proper osteotomy and osteotomy site, and how to calculate the correct angles,” Yan Wang, MD, said during his presentation.
In a retrospective study, Wang and colleagues reviewed information for 448 patients with ankylosing spondylitis kyphosis who underwent spinal osteotomy. Patients either underwent one-level transpedicular spinal osteotomy or two-level transpedicular osteotomy from T12-L3, based on the apex of kyphosis, deformity type and neurological conditions. Radiological parameters were measured preoperatively and postoperatively. Investigators recorded any complications.
Researchers found patients were able to walk with horizontal vision and lie on their backs postoperatively. In patients who underwent two-level osteotomy, the chin-brow vertical angle improved from 68.3° to 8.2°. This measurement went from 46.2° to 4.2° in patients who underwent one-level osteotomy. Investigators noted that in patients who underwent two-level osteotomy, the mean sagittal balance improved from 29.4 cm to 8 cm. This went from 18 cm to 4.3 cm in those who underwent one-level osteotomy.
At the superior site of the osteotomy, the amount of correction in the two-level group was 27.7° and was 42.1° at the inferior site. In the one-level group, it was 46.2°. There were no major complications in the study. Investigators found 32 patients with one or two complications, which included transient neurological deficit, vascular laceration bleeding, infections, postoperative low back pain, a broken spinal rod, pedicle screw pull out, non-fusion at the osteotomy site and cerebrospinal fluid leaks.
“Two-level spinal osteotomy show[s] risk tendency of higher operation-related complications,” the researchers wrote in their abstract. – by Monica Jaramillo
Reference:
Wang Y, et al. Paper #39. Presented at: Scoliosis Research Society Annual Meeting; Sept. 6-9, 2017; Philadelphia.
Disclosure: Wang reports no relevant financial disclosures.