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Loss of correction in the treatment of thoracolumbar kyphosis secondary to ankylosing spondylitis: a comparison between Smith-Petersen osteotomies and pedicle subtraction osteotomy.
J Spinal Disord Tech. 2012 Oct; 25(7):383-90.JS

Abstract

STUDY DESIGN

Retrospective comparison of database patients.

OBJECTIVE

To evaluate the difference of loss of correction between Smith-Petersen osteotomies (SPOs) and pedicle subtraction osteotomy (PSO) in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis (AS).

SUMMARY OF BACKGROUND DATA

SPOs and PSO are reported to be the 2 major techniques for correction of thoracolumbar kyphosis resulting from AS. Previous studies have tried to compare the indication, technical aspects, correction obtained, and complication rates between the aforementioned 2 techniques. However, reports addressing a comparison of loss of correction between SPOs and PSO are limited.

MATERIALS AND METHODS

On the basis of the types of osteotomies, 50 patients were divided into 2 groups: (1) SPOs group (n=19) including 16 male and 3 female patients, with an age range from 21 to 40 years (mean 27 y). The preoperative global kyphosis (GK) ranged from 41 to 99 degrees (average 64.6±25.6 degrees); (2) PSO group (n=31) consisted of 26 male and 5 female patients, with an age range from 22 to 54 years (mean 36 y). The preoperative GK was 50 to 96 degrees (average 73.7±23.6 degrees). Radiographic parameters including sagittal vertical axis, T12-S1 lordosis, GK, and angle of fusion levels were measured.

RESULTS

Both groups showed similar preoperative and postoperative thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. The average GK was corrected to 25.5 degrees and 31.4 degrees in SPOs group and PSO group, respectively. All cases were followed for a minimum of 2 years. At the last follow-up, mean loss of correction in the fusion levels were 6.1 degrees in SPOs group and 1.3 degrees in PSO group, respectively. The difference was statistically significant (P=0.034). Loss of correction of >5 degrees occurred in 4 cases (21.1%) in SPOs group, and 5 cases (16.1%) in PSO group.

CONCLUSIONS

Both SPOs and PSO showed similar effect in correcting the thoracolumbar kyphosis secondary to AS. However, patients treated with the SPOs technique showed higher risk in loss of correction in the instrumented region.

Authors+Show Affiliations

Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21705917

Citation

Zhu, Zezhang, et al. "Loss of Correction in the Treatment of Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis: a Comparison Between Smith-Petersen Osteotomies and Pedicle Subtraction Osteotomy." Journal of Spinal Disorders & Techniques, vol. 25, no. 7, 2012, pp. 383-90.
Zhu Z, Wang X, Qian B, et al. Loss of correction in the treatment of thoracolumbar kyphosis secondary to ankylosing spondylitis: a comparison between Smith-Petersen osteotomies and pedicle subtraction osteotomy. J Spinal Disord Tech. 2012;25(7):383-90.
Zhu, Z., Wang, X., Qian, B., Wang, B., Yu, Y., Zhao, Q., & Qiu, Y. (2012). Loss of correction in the treatment of thoracolumbar kyphosis secondary to ankylosing spondylitis: a comparison between Smith-Petersen osteotomies and pedicle subtraction osteotomy. Journal of Spinal Disorders & Techniques, 25(7), 383-90.
Zhu Z, et al. Loss of Correction in the Treatment of Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis: a Comparison Between Smith-Petersen Osteotomies and Pedicle Subtraction Osteotomy. J Spinal Disord Tech. 2012;25(7):383-90. PubMed PMID: 21705917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Loss of correction in the treatment of thoracolumbar kyphosis secondary to ankylosing spondylitis: a comparison between Smith-Petersen osteotomies and pedicle subtraction osteotomy. AU - Zhu,Zezhang, AU - Wang,Xinhua, AU - Qian,Bangping, AU - Wang,Bin, AU - Yu,Yang, AU - Zhao,Qinghua, AU - Qiu,Yong, PY - 2011/6/28/entrez PY - 2011/6/28/pubmed PY - 2013/3/6/medline SP - 383 EP - 90 JF - Journal of spinal disorders & techniques JO - J Spinal Disord Tech VL - 25 IS - 7 N2 - STUDY DESIGN: Retrospective comparison of database patients. OBJECTIVE: To evaluate the difference of loss of correction between Smith-Petersen osteotomies (SPOs) and pedicle subtraction osteotomy (PSO) in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: SPOs and PSO are reported to be the 2 major techniques for correction of thoracolumbar kyphosis resulting from AS. Previous studies have tried to compare the indication, technical aspects, correction obtained, and complication rates between the aforementioned 2 techniques. However, reports addressing a comparison of loss of correction between SPOs and PSO are limited. MATERIALS AND METHODS: On the basis of the types of osteotomies, 50 patients were divided into 2 groups: (1) SPOs group (n=19) including 16 male and 3 female patients, with an age range from 21 to 40 years (mean 27 y). The preoperative global kyphosis (GK) ranged from 41 to 99 degrees (average 64.6±25.6 degrees); (2) PSO group (n=31) consisted of 26 male and 5 female patients, with an age range from 22 to 54 years (mean 36 y). The preoperative GK was 50 to 96 degrees (average 73.7±23.6 degrees). Radiographic parameters including sagittal vertical axis, T12-S1 lordosis, GK, and angle of fusion levels were measured. RESULTS: Both groups showed similar preoperative and postoperative thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. The average GK was corrected to 25.5 degrees and 31.4 degrees in SPOs group and PSO group, respectively. All cases were followed for a minimum of 2 years. At the last follow-up, mean loss of correction in the fusion levels were 6.1 degrees in SPOs group and 1.3 degrees in PSO group, respectively. The difference was statistically significant (P=0.034). Loss of correction of >5 degrees occurred in 4 cases (21.1%) in SPOs group, and 5 cases (16.1%) in PSO group. CONCLUSIONS: Both SPOs and PSO showed similar effect in correcting the thoracolumbar kyphosis secondary to AS. However, patients treated with the SPOs technique showed higher risk in loss of correction in the instrumented region. SN - 1539-2465 UR - https://www.unboundmedicine.com/medline/citation/21705917/Loss_of_correction_in_the_treatment_of_thoracolumbar_kyphosis_secondary_to_ankylosing_spondylitis:_a_comparison_between_Smith_Petersen_osteotomies_and_pedicle_subtraction_osteotomy_ L2 - https://doi.org/10.1097/BSD.0b013e318224b199 DB - PRIME DP - Unbound Medicine ER -