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Long-term outcomes of vertebral column resection for kyphosis in patients with cured spinal tuberculosis: average 8-year follow-up.
J Neurosurg Spine 2016; 24(5):777-85JN

Abstract

OBJECTIVE

The authors conducted a study to evaluate the long-term clinical and radiographic outcomes of vertebral column resection (VCR) for kyphosis in patients with cured spinal tuberculosis.

METHODS

This was a retrospective study. Between 2003 and 2009, 28 consecutive patients with cured spinal tuberculosis underwent VCR for kyphosis in which the target vertebra was removed completely. Autologous iliac crest bone graft or titanium mesh packed with autograft was placed into the osteotomy gap to reconstruct the spine for anterior column stability. Posterior pedicle screw fixation and fusion were typically performed. Radiographic parameters, including kyphosis angle and sagittal balance, were measured, and visual analog scale score, America Spinal Injury Association grade, Scoliosis Research Society outcome instrument (SRS-22) score, Oswestry Disability Index, patient satisfaction index, and long-term complications were evaluated.

RESULTS

This study included 12 males and 16 females, with an average age of 20.9 years at the time of surgery. The average follow-up was 96.9 months. No deaths occurred in this study. At the final follow-up, the kyphosis angle improved from the preoperative average of 70.7° to the final follow-up average of 30.2°, and the average kyphosis correction loss was 8.5°. The sagittal balance averaged 15.4 mm before surgery, 2.8 mm after surgery, and 5.4 mm at the final followup. Thirteen patients showed improvement of more than 1 America Spinal Injury Association grade. The visual analog scale, Oswestry Disability Index, and SRS-22 scores improved significantly, and the overall satisfaction rate was 92.9%. Adjacent-segment degeneration occurred in 3 patients. No severe instrumentation-related complications were observed.

CONCLUSIONS

The long-term safety and efficacy of the VCR technique for treating spinal tuberculosis-related kyphosis were favorable, and no severe late-stage complications appeared. Lumbar tubercular kyphosis showed a tendency for sagittal decompensation within the first 3 postoperative years. Cases of adjacent-segment degenerations were relatively few and mild without clinical symptoms.

Authors+Show Affiliations

Department of Spine Surgery, Second Xiangya Hospital of Central South University; and.Department of Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China.Department of Spine Surgery, Second Xiangya Hospital of Central South University; and.Department of Spine Surgery, Second Xiangya Hospital of Central South University; and.Department of Spine Surgery, Second Xiangya Hospital of Central South University; and.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26745350

Citation

Liu, Congcong, et al. "Long-term Outcomes of Vertebral Column Resection for Kyphosis in Patients With Cured Spinal Tuberculosis: Average 8-year Follow-up." Journal of Neurosurgery. Spine, vol. 24, no. 5, 2016, pp. 777-85.
Liu C, Lin L, Wang W, et al. Long-term outcomes of vertebral column resection for kyphosis in patients with cured spinal tuberculosis: average 8-year follow-up. J Neurosurg Spine. 2016;24(5):777-85.
Liu, C., Lin, L., Wang, W., Lv, G., & Deng, Y. (2016). Long-term outcomes of vertebral column resection for kyphosis in patients with cured spinal tuberculosis: average 8-year follow-up. Journal of Neurosurgery. Spine, 24(5), pp. 777-85. doi:10.3171/2015.8.SPINE15534.
Liu C, et al. Long-term Outcomes of Vertebral Column Resection for Kyphosis in Patients With Cured Spinal Tuberculosis: Average 8-year Follow-up. J Neurosurg Spine. 2016;24(5):777-85. PubMed PMID: 26745350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of vertebral column resection for kyphosis in patients with cured spinal tuberculosis: average 8-year follow-up. AU - Liu,Congcong, AU - Lin,Li, AU - Wang,Weixing, AU - Lv,Guohua, AU - Deng,Youwen, Y1 - 2016/01/08/ PY - 2016/1/9/entrez PY - 2016/1/9/pubmed PY - 2016/12/15/medline KW - ASD = adjacent-segment degeneration KW - ASIA = America Spinal Injury Association KW - ODI = Oswestry Disability Index KW - PSI = patient satisfaction index KW - SVA = sagittal vertical axis KW - VAS = visual analog scale KW - VCR = vertebral column resection KW - long-term outcomes KW - spine KW - technique KW - tuberculosis kyphosis KW - vertebral column resection SP - 777 EP - 85 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 24 IS - 5 N2 - OBJECTIVE The authors conducted a study to evaluate the long-term clinical and radiographic outcomes of vertebral column resection (VCR) for kyphosis in patients with cured spinal tuberculosis. METHODS This was a retrospective study. Between 2003 and 2009, 28 consecutive patients with cured spinal tuberculosis underwent VCR for kyphosis in which the target vertebra was removed completely. Autologous iliac crest bone graft or titanium mesh packed with autograft was placed into the osteotomy gap to reconstruct the spine for anterior column stability. Posterior pedicle screw fixation and fusion were typically performed. Radiographic parameters, including kyphosis angle and sagittal balance, were measured, and visual analog scale score, America Spinal Injury Association grade, Scoliosis Research Society outcome instrument (SRS-22) score, Oswestry Disability Index, patient satisfaction index, and long-term complications were evaluated. RESULTS This study included 12 males and 16 females, with an average age of 20.9 years at the time of surgery. The average follow-up was 96.9 months. No deaths occurred in this study. At the final follow-up, the kyphosis angle improved from the preoperative average of 70.7° to the final follow-up average of 30.2°, and the average kyphosis correction loss was 8.5°. The sagittal balance averaged 15.4 mm before surgery, 2.8 mm after surgery, and 5.4 mm at the final followup. Thirteen patients showed improvement of more than 1 America Spinal Injury Association grade. The visual analog scale, Oswestry Disability Index, and SRS-22 scores improved significantly, and the overall satisfaction rate was 92.9%. Adjacent-segment degeneration occurred in 3 patients. No severe instrumentation-related complications were observed. CONCLUSIONS The long-term safety and efficacy of the VCR technique for treating spinal tuberculosis-related kyphosis were favorable, and no severe late-stage complications appeared. Lumbar tubercular kyphosis showed a tendency for sagittal decompensation within the first 3 postoperative years. Cases of adjacent-segment degenerations were relatively few and mild without clinical symptoms. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/26745350/Long_term_outcomes_of_vertebral_column_resection_for_kyphosis_in_patients_with_cured_spinal_tuberculosis:_average_8_year_follow_up_ L2 - https://thejns.org/doi/10.3171/2015.8.SPINE15534 DB - PRIME DP - Unbound Medicine ER -