Reposterior individualized three-column osteotomy for tuberculous spinal angular kyphosis deformity
Objective To investigate the efficacy of posterior three-columns osteotomy in the treatment of severe tubercu-lous angular kyphosis.Methods Total of 33 patients with severe tuberculous angular kyphosis were treated with posterior three-columns osteotomy from January 2006 to January 2019 including 24 males and 9 females with an average age of(40.6±23.3)years old ranging from 15 to 62 years old and an average disease duration of(23.5±15.5)years ranging from 4 to 40 years.The Cobb's angle of kyphosis was(118.65±28.82)°.Interradicular bone-disc-bone osteotomy(BDBO),posterior-only vertebral col-umn resection(PVCR)and posterior multilevel vertebral osteotomy(PMVO)were performed to correct spinal deformity indi-vidually.The visual analogue scale(VAS),Oswestry disability index(ODI),sagittal vertical axis(SVA),ASIA spinal cord functional classification and motor function score,and deformity correction rate were measured and statistically analyzed be-fore,after and at the final follow-up.Results Total of 33 patients were followed up from 15 to 96 months with an average of(38.00±6.38)months.The last follow-up of kyphosis Cobb angle(23.88±5.45)° showed no significant loss from postoperative 12 months(20.40±9.13)°,P＞0.05.The SVA,VAS,ODI and ASIA spinal cord functional classification and motor function score were significantly improved at 1 year and last follow-up after operation(P＜0.01).The fusion time of the osteotomy site was(18.50±5.16)months.The ASIA classification of 15 patients with spinal cord injury were improved by at least 2 grades after operation,and their daily life and work ability were various levels of restored.Postoperative complications of spinal cord injury occurred in 3 cases.Conclusion Posterior three-columns osteotomy is the most effective method for the treatment of angular kyphosis of spinal tuberculosis.Careful preoperative design and individualized osteotomy can not only correct the deformity,but also a successful decompression to the spinal cord and promote the recovery of spinal cord function.
万方数据
维普
