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Apical segmental resection osteotomy with dual axial rotation corrective technique for severe focal kyphosis of the thoracolumbar spine.
J Neurosurg Spine. 2011 Jan; 14(1):106-13.JN

Abstract

OBJECT

in this paper, the authors' goal was to evaluate the feasibility, safety, and efficacy of apical segment resection osteotomy with dual axial rotation correction for severe focal kyphosis by examining outcomes.

METHODS

between May 2004 and December 2006, the authors treated 23 patients with severe focal kyphosis (average Cobb angle 86.9°, range 50°-130°) using apical segmental resection osteotomy with dual axial rotation correction and instrumented anterior column reconstruction and fusion. Radiographic assessment of sagittal plane balance and kyphotic Cobb angle (including a scoliosis Cobb angle in 9 cases) was performed in each patient before and immediately after surgery and at the last follow-up (minimum 2 years). The Frankel grading system for neurological function and Oswestry Disability Index for quality of life were evaluated before surgery and at the last follow-up. The patient satisfaction index was also used for clinical evaluation at the last follow-up.

RESULTS

the mean surgical time was 6.7 hours. The average blood loss was 2960 ml. All patients underwent follow-up for 2 or more years after surgery. The fusion rate was 95.65%. The average kyphotic angle improved from 86.9° preoperatively to 25.6° immediately postoperatively, with an average correction rate of 72.17%. At the last follow-up, the average kyphotic angle was 27.4°, making the final correction rate 69.87%. The sagittal plane balance was significantly improved at the last follow-up. Preoperatively, 15 patients had neurological deficits, and the Frankel grade was E in 8 cases, D in 8 cases, C in 6 cases, and B in 1 case. At the last follow-up, 15 cases were Grade E, 5 were Grade D, and 3 were Grade C. The average improvement in the Oswestry Disability Index score was 43.30%. The patient satisfaction index result showed a total satisfaction rate of 91.30%. Complications included 1 case of late neurological deficit due to shifting of an expandable artificial vertebra, 5 cases of nerve root injury, 3 cases of dural tear, and 1 case of transient lower-extremity weakness due to insufficient blood supply to the spinal cord during surgery.

CONCLUSIONS

apical segmental resection osteotomy with dual axial rotation correction and instrumented fusion is an effective and safe way to treat severe focal kyphosis of the thoracolumbar spine.

Authors+Show Affiliations

Department of Orthopedics, Peking University, 3rd Hospital, Beijing, China. chenzq5803@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21142456

Citation

Chen, Zhongqiang, et al. "Apical Segmental Resection Osteotomy With Dual Axial Rotation Corrective Technique for Severe Focal Kyphosis of the Thoracolumbar Spine." Journal of Neurosurgery. Spine, vol. 14, no. 1, 2011, pp. 106-13.
Chen Z, Zeng Y, Li W, et al. Apical segmental resection osteotomy with dual axial rotation corrective technique for severe focal kyphosis of the thoracolumbar spine. J Neurosurg Spine. 2011;14(1):106-13.
Chen, Z., Zeng, Y., Li, W., Guo, Z., Qi, Q., & Sun, C. (2011). Apical segmental resection osteotomy with dual axial rotation corrective technique for severe focal kyphosis of the thoracolumbar spine. Journal of Neurosurgery. Spine, 14(1), 106-13. https://doi.org/10.3171/2010.9.SPINE10257
Chen Z, et al. Apical Segmental Resection Osteotomy With Dual Axial Rotation Corrective Technique for Severe Focal Kyphosis of the Thoracolumbar Spine. J Neurosurg Spine. 2011;14(1):106-13. PubMed PMID: 21142456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Apical segmental resection osteotomy with dual axial rotation corrective technique for severe focal kyphosis of the thoracolumbar spine. AU - Chen,Zhongqiang, AU - Zeng,Yan, AU - Li,Weishi, AU - Guo,Zhaoqing, AU - Qi,Qiang, AU - Sun,Chuiguo, Y1 - 2010/12/10/ PY - 2010/12/15/entrez PY - 2010/12/15/pubmed PY - 2011/1/28/medline SP - 106 EP - 13 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 14 IS - 1 N2 - OBJECT: in this paper, the authors' goal was to evaluate the feasibility, safety, and efficacy of apical segment resection osteotomy with dual axial rotation correction for severe focal kyphosis by examining outcomes. METHODS: between May 2004 and December 2006, the authors treated 23 patients with severe focal kyphosis (average Cobb angle 86.9°, range 50°-130°) using apical segmental resection osteotomy with dual axial rotation correction and instrumented anterior column reconstruction and fusion. Radiographic assessment of sagittal plane balance and kyphotic Cobb angle (including a scoliosis Cobb angle in 9 cases) was performed in each patient before and immediately after surgery and at the last follow-up (minimum 2 years). The Frankel grading system for neurological function and Oswestry Disability Index for quality of life were evaluated before surgery and at the last follow-up. The patient satisfaction index was also used for clinical evaluation at the last follow-up. RESULTS: the mean surgical time was 6.7 hours. The average blood loss was 2960 ml. All patients underwent follow-up for 2 or more years after surgery. The fusion rate was 95.65%. The average kyphotic angle improved from 86.9° preoperatively to 25.6° immediately postoperatively, with an average correction rate of 72.17%. At the last follow-up, the average kyphotic angle was 27.4°, making the final correction rate 69.87%. The sagittal plane balance was significantly improved at the last follow-up. Preoperatively, 15 patients had neurological deficits, and the Frankel grade was E in 8 cases, D in 8 cases, C in 6 cases, and B in 1 case. At the last follow-up, 15 cases were Grade E, 5 were Grade D, and 3 were Grade C. The average improvement in the Oswestry Disability Index score was 43.30%. The patient satisfaction index result showed a total satisfaction rate of 91.30%. Complications included 1 case of late neurological deficit due to shifting of an expandable artificial vertebra, 5 cases of nerve root injury, 3 cases of dural tear, and 1 case of transient lower-extremity weakness due to insufficient blood supply to the spinal cord during surgery. CONCLUSIONS: apical segmental resection osteotomy with dual axial rotation correction and instrumented fusion is an effective and safe way to treat severe focal kyphosis of the thoracolumbar spine. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/21142456/Apical_segmental_resection_osteotomy_with_dual_axial_rotation_corrective_technique_for_severe_focal_kyphosis_of_the_thoracolumbar_spine_ L2 - https://thejns.org/doi/10.3171/2010.9.SPINE10257 DB - PRIME DP - Unbound Medicine ER -