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Expanded eggshell procedure combined with closing-opening technique (a modified vertebral column resection) for the treatment of thoracic and thoracolumbar angular kyphosis.
J Neurosurg Spine 2015; 23(1):42-8JN

Abstract

OBJECT

The purpose of this study was to determine the efficacy of a modified vertebral column resection for the treatment of thoracolumbar angular kyphosis.

METHODS

A total of 13 patients (8 male, 5 female) with thoracolumbar kyphosis (kyphotic angle > 60°) were included in this study (Group A). There were 3 patients with failure of spinal formation (Type 1 deformity), 6 patients with old thoracic or lumbar compression fracture, and 4 patients with old spinal tuberculosis (including 1 case of T3-5 vertebral malunion). The average preoperative kyphotic angle was 67.3° (range 62°-75°). Each patient underwent an expanded eggshell procedure combined with the closing-opening technique for the treatment of thoracolumbar angular kyphosis. Sixteen patients who were previously treated with a closing-opening wedge osteotomy in the same spine classification group (kyphotic angle > 60°) were used as a control group (Group B).

RESULTS

In Group A, the average (± SD) operative time was 400 ± 60 minutes, and the average blood loss was 960 ± 120 ml. There were no surgery-related complications observed during or after the operations. The average local kyphotic angle was 20.3° (range 18°-24.5°), and the average correction rate was 68.7%. In Group B, the average operative time was 470 ± 90 minutes, and the average blood loss was 2600 ± 1600 ml (range 1200-8200 ml). There were segmental vessels and spinal canal venous plexus injury in 1 case, spinal cord injury in 1 case, dural tearing in 2 cases, pleural rupture in 2 cases, and hemothorax and pneumothorax in 1 case. Each patient had more than 2 years of follow-up. At the latest follow-up examination, the average regional kyphotic angle was 19.9° ± 9.1° (range 19°-34°), and there was no significant loss of correction (p > 0.05). There was greater blood loss and a higher complication rate in Group B than in Group A (p < 0.05).

CONCLUSIONS

An expanded eggshell procedure combined with the closing-opening technique for the treatment of thoracolumbar angular kyphosis resulted in significant reduction of the kyphotic angle, few complications, and good follow-up results. However, a larger series of patients and long-term follow-up results is still required to verify the effectiveness and safety of this method.

Authors+Show Affiliations

Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25909274

Citation

Liu, Xinyu, et al. "Expanded Eggshell Procedure Combined With Closing-opening Technique (a Modified Vertebral Column Resection) for the Treatment of Thoracic and Thoracolumbar Angular Kyphosis." Journal of Neurosurgery. Spine, vol. 23, no. 1, 2015, pp. 42-8.
Liu X, Yuan S, Tian Y, et al. Expanded eggshell procedure combined with closing-opening technique (a modified vertebral column resection) for the treatment of thoracic and thoracolumbar angular kyphosis. J Neurosurg Spine. 2015;23(1):42-8.
Liu, X., Yuan, S., Tian, Y., Wang, L., Zheng, Y., & Li, J. (2015). Expanded eggshell procedure combined with closing-opening technique (a modified vertebral column resection) for the treatment of thoracic and thoracolumbar angular kyphosis. Journal of Neurosurgery. Spine, 23(1), pp. 42-8. doi:10.3171/2014.11.SPINE14710.
Liu X, et al. Expanded Eggshell Procedure Combined With Closing-opening Technique (a Modified Vertebral Column Resection) for the Treatment of Thoracic and Thoracolumbar Angular Kyphosis. J Neurosurg Spine. 2015;23(1):42-8. PubMed PMID: 25909274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Expanded eggshell procedure combined with closing-opening technique (a modified vertebral column resection) for the treatment of thoracic and thoracolumbar angular kyphosis. AU - Liu,Xinyu, AU - Yuan,Suomao, AU - Tian,Yonghao, AU - Wang,Lianlei, AU - Zheng,Yanping, AU - Li,Jianmin, Y1 - 2015/04/24/ PY - 2015/4/25/entrez PY - 2015/4/25/pubmed PY - 2015/9/8/medline KW - ASIA = American Spinal Injury Association KW - COWO = closing-opening wedge osteotomy KW - LL = lumbar lordosis KW - PI = pelvic incidence KW - PSO = pedicle subtraction osteotomy KW - PT = pelvic tilt KW - PVCR = posterior vertebral column resection KW - RKA = regional kyphotic angle KW - SPO = Smith-Petersen osteotomy KW - SVA = sagittal vertical axis KW - TK = thoracic kyphosis KW - VAS = visual analog scale KW - VCR = vertebral column resection KW - closing-opening procedure KW - correction KW - eggshell KW - kyphosis KW - technique KW - thoracic spine SP - 42 EP - 8 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 23 IS - 1 N2 - OBJECT: The purpose of this study was to determine the efficacy of a modified vertebral column resection for the treatment of thoracolumbar angular kyphosis. METHODS: A total of 13 patients (8 male, 5 female) with thoracolumbar kyphosis (kyphotic angle > 60°) were included in this study (Group A). There were 3 patients with failure of spinal formation (Type 1 deformity), 6 patients with old thoracic or lumbar compression fracture, and 4 patients with old spinal tuberculosis (including 1 case of T3-5 vertebral malunion). The average preoperative kyphotic angle was 67.3° (range 62°-75°). Each patient underwent an expanded eggshell procedure combined with the closing-opening technique for the treatment of thoracolumbar angular kyphosis. Sixteen patients who were previously treated with a closing-opening wedge osteotomy in the same spine classification group (kyphotic angle > 60°) were used as a control group (Group B). RESULTS: In Group A, the average (± SD) operative time was 400 ± 60 minutes, and the average blood loss was 960 ± 120 ml. There were no surgery-related complications observed during or after the operations. The average local kyphotic angle was 20.3° (range 18°-24.5°), and the average correction rate was 68.7%. In Group B, the average operative time was 470 ± 90 minutes, and the average blood loss was 2600 ± 1600 ml (range 1200-8200 ml). There were segmental vessels and spinal canal venous plexus injury in 1 case, spinal cord injury in 1 case, dural tearing in 2 cases, pleural rupture in 2 cases, and hemothorax and pneumothorax in 1 case. Each patient had more than 2 years of follow-up. At the latest follow-up examination, the average regional kyphotic angle was 19.9° ± 9.1° (range 19°-34°), and there was no significant loss of correction (p > 0.05). There was greater blood loss and a higher complication rate in Group B than in Group A (p < 0.05). CONCLUSIONS: An expanded eggshell procedure combined with the closing-opening technique for the treatment of thoracolumbar angular kyphosis resulted in significant reduction of the kyphotic angle, few complications, and good follow-up results. However, a larger series of patients and long-term follow-up results is still required to verify the effectiveness and safety of this method. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/25909274/Expanded_eggshell_procedure_combined_with_closing_opening_technique__a_modified_vertebral_column_resection__for_the_treatment_of_thoracic_and_thoracolumbar_angular_kyphosis_ L2 - https://thejns.org/doi/10.3171/2014.11.SPINE14710 DB - PRIME DP - Unbound Medicine ER -