Three column osteotomy for adult spine deformity: comparison of outcomes and complications between kyphosis and kyphoscoliosis.

Related Articles

Three column osteotomy for adult spine deformity: comparison of outcomes and complications between kyphosis and kyphoscoliosis.

Br J Neurosurg. 2018 Jan 15;:1-5

Authors: Qiao J, Xiao L, Sun X, Liu Z, Zhu Z, Qian B, Qiu Y

Abstract
BACKGROUND: To compare the surgical outcomes and complications between kyphosis and kyphoscoliosis when using three-column osteotomies.
METHODS: Adult spine deformity (ASD) patients with three column osteotomies from March 2005 to December 2014 in our center were retrospectively reviewed. Pre- and postoperative standing postero-anterior and lateral radiographs of the entire spine were obtained. Scoliosis Research Society-22 questionnaire [SRS-22] and Oswestry Disability Index [ODI] were administered preoperatively, postoperatively (surveys within 2 months after surgery), and at final follow-up. Patients were assigned to one of two groups according to pre-operative coronal curve magnitude: (1) if coronal curve <10°, patients were assigned to kyphosis group (K group); (2) if coronal curve >40°, patients were assigned to kyphoscoliosis group (S group).
RESULTS: 33 ASD patients were assigned to the kyphosis group (K group), of which 26 received PSO (pedicle subtraction osteotomy) and 7 VCR (vertebral column resection). 76 patients were assigned to kyphoscoliosis group (S group), of which 50 received PSO and 26 VCR. Patients in the K group were significantly older than in the S group (42.8 vs. 33.7 years, p < .05). Significantly longer OT (operation time) and more EBL (estimated blood loss) were observed in the S group as compared to K group (OT: 282 vs. 205 min, p < .05; EBL: 1827 vs. 1214ml, p < .05). No significant difference was noted for number of fusion levels between the groups (12.4 vs. 12.7, p > .05). Pre-operative radiographic parameters demonstrated no difference of GK (global kyphosis) and SVA (sagittal vertical axis) between the two groups (GK: 74.7° vs 76.2°, p > .05; SVA:53.2 vs. 55.7mm, p > .05). K group had larger KF than S group (26% vs. 15%, p < .05). Overall complication rate was higher in S group than in K group (30.3% vs. 18.2%, p < .05). No difference of neurological complication rates between the two groups (9.1% vs. 10.5%, p > .05).
CONCLUSIONS: Kyphoscoliosis group had less KF, GK correction and more OT, EBL and surgical complications when receiving three column osteotomies.

PMID: 29334774 [PubMed - as supplied by publisher]

http://ift.tt/2mMhJfQ