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- Title
Posterior Spinal Osteotomy Surgery is an Effective Method for the Correction of Progressive Thoracolumbar Kyphosis in Patients With Achondroplasia.
- Authors
Leilei Xu; Chao Xia; Yong Qiu; Zezhang Zhu
- Abstract
Introduction: Progressive thoracolumbar kyphosis (TLK) is a common manifestation in patients with achondroplasia. To date, few papers have investigated the outcome of correction surgery for TLK in this type of patients. The current study aims at evaluating the outcome of posterior spinal osteotomy surgery for TLK in pediatric patients with achondroplasia. Materials and methods: 14 achondroplastic patients undergoing one-stage posterior surgery for progressive TLK were reviewed. The osteotomy procedures included Smith-Petersen osteotomy (SPO) in 12 patients and pedicle subtraction osteotomy (PSO) in 2 patients. Correction rate of kyphotic deformity, fusion levels, density of pedicle screw, surgical complications, and patient satisfactory index (PSI) were evaluated for each patient. Results: The mean age at surgery was 9.1 ± 2.9 years (range, 5-13), with an average follow-up period of 47.8 ± 16.3 months (range, 24-84). The mean preoperative kyphotic angle was 58.3° ± 17.1° (range, 42° - 91°), which was corrected to 14.7° ± 6.4° with a mean correction rate of 74.8%. The mean curve magnitude was 40.5° ± 16.7°, which was corrected to 11.5° ± 6.8° with a mean correction rate of 71.6%. The average percentage of apical vertebral wedging was improved from 49.4% ± 12.3% before surgery to 26.6% ± 6.7% at the final follow up. There was no case with significant loss of correction or neurological symptoms during the follow-up. 13 patients were satisfied with the surgical results with a PSI of 92.9%. The perioperative complications included one case of dural tear concomitant with transient neurologic impairment and one case of infection at the incision site. Conclusions: The one-stage posterior osteotomy surgery with segmental instrumentation is a safe and effective surgical option for progressive TLK in pediatric patients with achondroplasia. The wedged apical vertebral can be spontaneously improved in the long-term follow-up. We recommended that early surgical intervention in childhood should be performed for achondroplastic patients with progressive deformities.
- Publication
Global Spine Journal, 2018, Vol 8, p145S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771030