IR@PKUHSC  > 北京大学第三临床医学院  > 骨科
学科主题临床医学
Clinical and radiographic evaluation of posterior surgical correction for the treatment of moderate to severe post-tuberculosis kyphosis in 36 cases with a minimum 2-year follow-up Clinical article
Zeng, Yan1; Chen, Zhongqiang1; Qi, Qiang1; Guo, Zhaoqing1; Li, Weishi1; Sun, Chuiguo1; White, Andrew P.2
关键词post-tuberculosis kyphosis moderate to severe kyphosis kyphosis correction posterior corrective surgery Pott disease degenerative disease
刊名JOURNAL OF NEUROSURGERY-SPINE
2012-04-01
DOI10.3171/2011.12.SPINE11568
16期:4页:351-358
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Surgery
研究领域[WOS]Neurosciences & Neurology ; Surgery
关键词[WOS]FIXED SAGITTAL IMBALANCE ; THORACOLUMBAR KYPHOSIS ; ANKYLOSING-SPONDYLITIS ; WEDGE OSTEOTOMY ; DEFORMITY ; SPINE ; BALANCE
英文摘要

Object. The object of this study was to compare the clinical and radiographic outcomes of 36 patients with post-tuberculosis kyphosis who underwent one of two types of osteotomy.

Methods. Each patient underwent single-stage correction via a posterior surgical approach. A modified pedicle subtraction osteotomy (mPSO) was performed when the kyphotic deformity was less than 70 (7 cases), whereas a posterior vertebral column resection (VCR) was performed when the kyphotic deformity exceeded 700 (29 cases). Full-length standing radiographs were obtained before surgery and at follow-up visits. These images were used to measure the kyphosis angle; sagittal alignment of the lumbar, thoracic, and cervical regions; and sagittal balance of the spine. Back pain was rated using the visual analog scale (VAS), and neurological function was classified based on the American Spinal Injury Association (ASIA) grading system. Each patient′s overall satisfaction with surgical treatment was measured with the Patient Satisfaction Index. For purposes of comparison, patients were studied in 2 groups based on the region of their kyphotic apex. Half of the cohort had apical kyphosis in the lower thoracic spine or thoracolumbar junction (TL group). Using both radiographic and clinical assessments, the authors compared this group with the other half of the patients who had apical kyphosis in the upper to mid thoracic spine (MT group).

Results. The cohort included 15 males and 21 females, with an average age of 34 years at the time of surgery. The minimum follow-up was 24 months, and the mean follow-up was 31 months. Following surgery, kyphosis across the treated segments was reduced by an average of 60 degrees. Lumbar lordosis also improved by an average of 24, and thoracic kyphosis improved by an average of 20 degrees. Both back pain and neurological function improved after surgical treatment. There was a 67% improvement in VAS scores, and 13 of the 36 patients had improvement in their ASIA grade. The 2 surgical procedures used for deformity correction (mPSO and VCR) demonstrated comparable radiographic and clinical results. Note, however, that differences were found in both radiographic and clinical outcomes in comparing patients who had lower thoracic or thoracolumbar (TL group) versus upper to midthoracic (MT group) apical kyphosis.

Conclusions. Posterior tubercular kyphosis can be effectively improved through corrective surgery, and deformity correction can be accompanied by improvement in clinical symptoms. When appropriately selected, both the mPSO and the VCR can be expected to yield satisfactory reduction of post-tuberculosis kyphotic deformities. Differences in radiographic and clinical outcomes should be anticipated, however, when treating such deformities in different regions of the spine. (http://thejns.org/doi/abs/10.3171/2011.12.SPINE11568)

语种英语
WOS记录号WOS:000301805200006
Citation statistics
Cited Times:13[WOS]   [WOS Record]     [Related Records in WOS]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/61772
Collection北京大学第三临床医学院_骨科
作者单位1.Peking Univ, Dept Orthoped, Hosp 3, Beijing 100191, Peoples R China
2.Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Carl J Shapiro Dept Orthopaed Surg, Boston, MA 02215 USA
Recommended Citation
GB/T 7714
Zeng, Yan,Chen, Zhongqiang,Qi, Qiang,et al. Clinical and radiographic evaluation of posterior surgical correction for the treatment of moderate to severe post-tuberculosis kyphosis in 36 cases with a minimum 2-year follow-up Clinical article[J]. JOURNAL OF NEUROSURGERY-SPINE,2012,16(4):351-358.
APA Zeng, Yan.,Chen, Zhongqiang.,Qi, Qiang.,Guo, Zhaoqing.,Li, Weishi.,...&White, Andrew P..(2012).Clinical and radiographic evaluation of posterior surgical correction for the treatment of moderate to severe post-tuberculosis kyphosis in 36 cases with a minimum 2-year follow-up Clinical article.JOURNAL OF NEUROSURGERY-SPINE,16(4),351-358.
MLA Zeng, Yan,et al."Clinical and radiographic evaluation of posterior surgical correction for the treatment of moderate to severe post-tuberculosis kyphosis in 36 cases with a minimum 2-year follow-up Clinical article".JOURNAL OF NEUROSURGERY-SPINE 16.4(2012):351-358.
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