Transpedicular closing wedge osteotomy in the treatment of thoracic and lumbar kyphotic deformity with different etiologies

摘要

Transpedicular closing wedge osteotomy (CWO) has become popular in correcting thoracic and lumbar kyphotic deformity (TLKD). Our study aims to evaluate the efficacy of CWO in treating TLKD of different etiologies. CWO was performed on 25 patients with thoracic and lumbar kyphosis, of whom 10 had ankylosing spondylitis, 10 had post-traumatic thoracolumbar fractures, and 5 had tuberculosis. Mean follow-up period was 24 months. Pre- and postoperative kyphotic Cobb angles and the horizontal distance between C7 and S1 in the lateral view were measured. Back pain and disability were assessed by visual analog score (VAS) and oswestry disability index (ODI). Postoperative complications were also recorded. Kyphotic deformity was successfully corrected, and 100 % osteotomic site fusion was obtained in all cases. Average operative duration was 255.6 min and blood loss was 1,675.6 ml. Average correction angels were 37.6°. The horizontal distance between C7 and S1 was 88.28 mm before the operation and 20.84 mm after the operation. Pre- and postoperative mean VAS of back pain in all cases was 7.6 and 2.6 respectively. Pre- and postoperative mean ODI was 61.8 and 27.32 receptively. Six complications were registered in six patients. Pedicle subtraction osteotomy is an effective and safe surgical method to correct thoracic and lumbar kyphosis of different etiologies.