Can fusion to S1 maintain favorable surgical outcomes following one-level pedicle subtraction osteotomy in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis?

2020 ◽  
Vol 29 (12) ◽  
pp. 3028-3037
Author(s):  
Ji-chen Huang ◽  
Wei-yi Diao ◽  
Bang-ping Qian ◽  
Bin Wang ◽  
Yang Yu ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Surgical Outcomes ◽  
Pedicle Subtraction Osteotomy ◽  
Thoracolumbar Kyphosis

scholarly journals Does the Level of Pedicle Subtraction Osteotomy Affect the Surgical Outcomes in Ankylosing Spondylitis-Related Thoracolumbar Kyphosis With the Same Curve Pattern?

2021 ◽  
pp. 219256822098071
Author(s):  
Zou-li Tang ◽  
Bang-ping Qian ◽  
Yong Qiu ◽  
Zhuo-jie Liu ◽  
Shi-zhou Zhao ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Surgical Outcomes ◽  
Statistical Significance ◽  
Pedicle Subtraction Osteotomy ◽  
Horizontal Line ◽  
Horizontal Distance ◽  
Thoracolumbar Kyphosis ◽  
Curve Pattern ◽  
Radiographic Parameters

Study Design: A retrospective study. Objective: To investigate the effect of pedicle subtraction osteotomy (PSO) level on the surgical outcomes in ankylosing spondylitis-related thoracolumbar kyphosis with the same curve pattern. Methods: ankylosing spondylitis (AS) patients with thoracolumbar kyphosis, who underwent 1-level lumbar PSO between March 2006 and June 2017, were retrospectively reviewed. Criteria for curve-matched thoracolumbar kyphosis were: (1) have same level of preoperative apex (pre-apex); (2) have similar global kyphosis (GK, the angle between the superior/inferior endplate of the maximally tilted upper and lower end vertebra) (the difference of GK less than 15˚). The radiographic parameters measured were sagittal vertical axis (SVA, the horizontal distance between the C7 plumb line and the posterosuperior corner of the S1), GK, thoracic kyphosis (TK, the angle between the T5 superior endplate and the T12 inferior endplate), lumbar lordosis (LL, the angle between the L1 and S1 superior endplate), sacral slope (SS, the angle between the sacral endplate and the horizontal line), pelvic tilt (PT, the angle between the vertical and the line joining the midpoint of the sacral plate and hip axis), and pelvic incidence (PI, the angle between the line vertical to the superior margin of S1 and the line connecting the sacral plate midpoint with the hip joint axis). All of these parameters and health-related quality of life (HRQoL, evaluated by preoperative and the last follow-up questionnaires including ODI and VAS) scores were collected before surgery and at the last follow-up. According to their osteotomy level, patients were devided into 2 sub-groups (L1 group and L2 group), and differences of these mentioned parameters between 2 groups were compared. Results: 26 curve-matched patients were recruited with a mean follow-up of 37.2 months. All patients improved significantly after surgery in HRQoL scores (VAS 1.6 vs 5.4, P < 0.001; ODI 11.9 vs 26.4, P < 0.001). Except for TK and PI, those radiographic parameters were also observed to be significantly changed after surgery. Compared to L2 group, PSO at L1 may have larger correction of TK (ΔTK -6.8 vs -0.3°, P = 0.164), PI (ΔPI -7.4 vs -0.7°, P = 0.364) and smaller correction of SVA (ΔSVA -105.3 vs -128.5 mm, P = 0.096), LL (ΔLL -31.1 vs -43.0°, P = 0.307) and SS (ΔSS 6.9 vs 12.2°, P = 0.279) but had no statistical significance. Conclusion: The results of this investigation showed that in AS-related thoracolumbar kyphosis patients with the same curve pattern, the different levels of osteotomy had little effect on the improvement of surgical outcomes. However, osteotomy at L2 is more likely to obtain a larger correction of SVA compared to osteotomy at L1.

Does postoperative PI-LL mismatching affect surgical outcomes in thoracolumbar kyphosis associated with ankylosing spondylitis patients?

2018 ◽  
Vol 169 ◽  
pp. 71-76 ◽  
Author(s):  
Zhuo-jie Liu ◽  
Bang-ping Qian ◽  
Yong Qiu ◽  
Sai-hu Mao ◽  
Jun Jiang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Surgical Outcomes ◽  
Thoracolumbar Kyphosis

scholarly journals Pedicle Subtraction Osteotomy for Correction of Severe Thoracolumbar Kyphosis in Ankylosing Spondylitis

2014 ◽  
Vol 6 (3) ◽  
pp. 257-258 ◽  
Author(s):  
Zhen Liu ◽  
Yong Qiu ◽  
Ze-zhang Zhu ◽  
Bang-ping Qian ◽  
Jun Qiao ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Pedicle Subtraction Osteotomy ◽  
Thoracolumbar Kyphosis

scholarly journals Radiographic findings for surgery-related complications after pedicle subtraction osteotomy for thoracolumbar kyphosis in 230 patients with ankylosing spondylitis

2020 ◽  
Vol 33 (3) ◽  
pp. 366-372
Author(s):  
Keun-Ho Lee ◽  
Ki-Tack Kim ◽  
Yong-Chan Kim ◽  
Joong-Won Lee ◽  
Kee-Yong Ha
Keyword(s):  
Ankylosing Spondylitis ◽  
Pedicle Screws ◽  
Pedicle Subtraction Osteotomy ◽  
Delayed Union ◽  
Mechanical Failure ◽  
Technical Failure ◽  
Thoracolumbar Kyphosis ◽  
Radiographic Findings ◽  
Coronal Imbalance ◽  
Surgical Technical

OBJECTIVEThe purpose of this study was to investigate the rate of and the risk factors for surgery-related complications demonstrated on radiography after pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis in patients with ankylosing spondylitis (AS).METHODSThe authors retrospectively reviewed the medical records of 230 consecutive patients with thoracolumbar kyphosis due to AS who had undergone 1-level PSO at a single institution in the period from 2010 to 2017. The causes of surgery-related complications were divided into two types: surgical/technical failure and mechanical failure.RESULTSThe patients consisted of 20 women and 210 men, with an average age of 43.4 years. The average follow-up period was 39.0 months. The preoperative sagittal vertical axis was 18.5 ± 69.3 cm, which improved to 4.9 ± 4.6 cm after PSO. Of the 77 patients (33.5%) who experienced minor or major surgery-related complications, 56 had complications related to surgical/technical failure (overall incidence 24.3%) and 21 had complications related to mechanical failure (overall incidence 9.1%). Fourteen patients (6.1%) underwent reoperation. However, among the 77 patients with complications, the rate of revision surgery was 18.2%. The most common radiological complications were as follows: sagittal translation in 24 patients, coronal imbalance in 20, under-correction in 8, delayed union in 8, and distal junctional failure and kyphosis in 8. The most common causes of reoperation were coronal imbalance in 4 patients, symptomatic malposition of pedicle screws in 3, and distal junctional failure in 3. Delayed union was statistically correlated with posterior sagittal translation (p = 0.007).CONCLUSIONSPSO can provide acceptable radiographic outcomes for the correction of thoracolumbar kyphosis in patients with AS. However, a high incidence of surgery-related complications related to mechanical failure and surgical technique can develop. Thorough radiographic investigation before and during surgery is needed to determine whether complete ossification occurs along the anterior and posterior longitudinal ligaments of the spine.

Lung Volume Change After Pedicle Subtraction Osteotomy in Patients With Ankylosing Spondylitis With Thoracolumbar Kyphosis

Spine ◽  
2015 ◽  
Vol 40 (4) ◽  
pp. 233-237 ◽  
Author(s):  
Guoying Zhang ◽  
Jun Fu ◽  
Yonggang Zhang ◽  
Wei Zhang ◽  
Xuesong Zhang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Volume Change ◽  
Lung Volume ◽  
Pedicle Subtraction Osteotomy ◽  
Thoracolumbar Kyphosis

scholarly journals Computer simulation of two-level pedicle subtraction osteotomy for severe thoracolumbar kyphosis in ankylosing spondylitis

2017 ◽  
Vol 51 (6) ◽  
pp. 666 ◽  
Author(s):  
Fang-Cai Li ◽  
Ning Zhang ◽  
Hao Li ◽  
Zheng-Kuan Xu ◽  
Wei-Shan Chen ◽  
...  
Keyword(s):  
Computer Simulation ◽  
Ankylosing Spondylitis ◽  
Pedicle Subtraction Osteotomy ◽  
Thoracolumbar Kyphosis
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