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Clinical outcome results of pedicle subtraction osteotomy in ankylosing spondylitis with kyphotic deformity

A prospective study was performed in 45 patients with ankylosing spondylitis. To assess the outcomes of decancellation pedicle subtraction extension osteotomy in ankylosing spondylitis patients with severe fixed kyphotic deformity. There have been several studies regarding correction of kyphotic def...

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Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2002-03, Vol.27 (6), p.612-618
Main Authors: KIM, Ki-Tack, SUK, Kyung-Soo, CHO, Yoon-Je, HONG, Gyu-Pyo, PARK, Byung-Joo
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description A prospective study was performed in 45 patients with ankylosing spondylitis. To assess the outcomes of decancellation pedicle subtraction extension osteotomy in ankylosing spondylitis patients with severe fixed kyphotic deformity. There have been several studies regarding correction of kyphotic deformity in ankylosing spondylitis. However, most of them concern surgical technique. There have been no reports concerning clinical results of decancellation pedicle subtraction osteotomy in ankylosing spondylitis. The kyphotic deformity was corrected by a one-stage pedicle subtraction extension osteotomy. Radiographic assessment for sagittal balance was performed by measuring thoracic kyphosis, lumbar lordosis, distance between the vertical line on anterosuperior point of T1 and that of S1, and sacral inclination. Chin brow-vertical angle was measured on the preoperative and postoperative clinical photograph of patients. Clinical outcomes were assessed by questionnaire measuring changes in physical function, indoor activity, outdoor activity, psychosocial activity, pain, and patient satisfaction with surgery. Final follow-up radiograph showed an increase in lumbar lordosis from 10 degrees to 44 degrees (an increase of 34 degrees), whereas thoracic kyphosis remained stable from 50 degrees to 54 degrees. Sagittal imbalance significantly improved from 94 to 8 mm, whereas sacral inclination increased from 8 degrees to 24 degrees. The chin brow-vertical angle was 32.0 degrees before surgery and 0.9 degrees after surgery. Satisfactory clinical outcome was achieved; however, clinical improvements did not correlate with changes in radiologic measurements. Most of the patients maintained good correction and had good clinical results. Based on the results of this study, pedicle subtraction extension osteotomy is effective for correction of kyphotic deformity in ankylosing spondylitis.
doi_str_mv 10.1097/00007632-200203150-00010
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To assess the outcomes of decancellation pedicle subtraction extension osteotomy in ankylosing spondylitis patients with severe fixed kyphotic deformity. There have been several studies regarding correction of kyphotic deformity in ankylosing spondylitis. However, most of them concern surgical technique. There have been no reports concerning clinical results of decancellation pedicle subtraction osteotomy in ankylosing spondylitis. The kyphotic deformity was corrected by a one-stage pedicle subtraction extension osteotomy. Radiographic assessment for sagittal balance was performed by measuring thoracic kyphosis, lumbar lordosis, distance between the vertical line on anterosuperior point of T1 and that of S1, and sacral inclination. Chin brow-vertical angle was measured on the preoperative and postoperative clinical photograph of patients. 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To assess the outcomes of decancellation pedicle subtraction extension osteotomy in ankylosing spondylitis patients with severe fixed kyphotic deformity. There have been several studies regarding correction of kyphotic deformity in ankylosing spondylitis. However, most of them concern surgical technique. There have been no reports concerning clinical results of decancellation pedicle subtraction osteotomy in ankylosing spondylitis. The kyphotic deformity was corrected by a one-stage pedicle subtraction extension osteotomy. Radiographic assessment for sagittal balance was performed by measuring thoracic kyphosis, lumbar lordosis, distance between the vertical line on anterosuperior point of T1 and that of S1, and sacral inclination. Chin brow-vertical angle was measured on the preoperative and postoperative clinical photograph of patients. Clinical outcomes were assessed by questionnaire measuring changes in physical function, indoor activity, outdoor activity, psychosocial activity, pain, and patient satisfaction with surgery. Final follow-up radiograph showed an increase in lumbar lordosis from 10 degrees to 44 degrees (an increase of 34 degrees), whereas thoracic kyphosis remained stable from 50 degrees to 54 degrees. Sagittal imbalance significantly improved from 94 to 8 mm, whereas sacral inclination increased from 8 degrees to 24 degrees. The chin brow-vertical angle was 32.0 degrees before surgery and 0.9 degrees after surgery. Satisfactory clinical outcome was achieved; however, clinical improvements did not correlate with changes in radiologic measurements. Most of the patients maintained good correction and had good clinical results. Based on the results of this study, pedicle subtraction extension osteotomy is effective for correction of kyphotic deformity in ankylosing spondylitis.</abstract><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>11884909</pmid><doi>10.1097/00007632-200203150-00010</doi><tpages>7</tpages></addata></record>
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identifier ISSN: 0362-2436
ispartof Spine (Philadelphia, Pa. 1976), 2002-03, Vol.27 (6), p.612-618
issn 0362-2436
1528-1159
language eng
recordid cdi_proquest_miscellaneous_71499962
source LWW Online
subjects Adolescent
Adult
Biological and medical sciences
Diseases of the osteoarticular system
Diseases of the spine
Female
Follow-Up Studies
Humans
Inflammatory joint diseases
Intestinal Pseudo-Obstruction - etiology
Kyphosis - complications
Kyphosis - diagnostic imaging
Kyphosis - surgery
Lordosis - complications
Lordosis - diagnostic imaging
Lordosis - surgery
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - surgery
Male
Medical sciences
Middle Aged
Nervous System Diseases - etiology
Osteotomy - adverse effects
Osteotomy - methods
Osteotomy - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Prospective Studies
Radiculopathy - etiology
Radiography
Recovery of Function
Spondylitis, Ankylosing - complications
Spondylitis, Ankylosing - diagnostic imaging
Spondylitis, Ankylosing - surgery
Thoracic Vertebrae - diagnostic imaging
Thoracic Vertebrae - surgery
Treatment Outcome
Tropical medicine
title Clinical outcome results of pedicle subtraction osteotomy in ankylosing spondylitis with kyphotic deformity
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