Artikel
Closing wedge osteotomy for treating post-traumatic kyphosis at thoraco-lumbar and lumbar levels
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
The goal of this study was to evaluate the results of one-segment posterior closing wedge osteotomy for treating of post-traumatic kyphosis comparing thoracolumbar (T12 – L1) and lumbar (L2 – L4) spinal levels.
Methods
13 consecutive patients underwent posterior closing wedge osteotomy for treating post-traumatic kyphosis. The mean time between injury and operation was 13 months (extreme 5 – 36). The average age at the time of surgery was 41 years (21 – 57). There were 8 thoracolumbar (T12 – L1) and 5 lumbar (L2 – L4) deformities. 9 patients had already been operated by posterior fixation.
Results
Three patients (23,1%) were lost to follow-up after 6 months post surgery. For the other 10 patients (76,9%), the average follow-up was 2.1 years (1.2 – 6). The average duration of surgery was 128 min (98 – 147). Solid fusion was achieved in all cases. Two transient partial neurological deficits, 1 dural tear, 1 implant failure, 1 wound seroma and 3 delayed wound closures were noted.
Conclusions
Although technically demanding, monosegmental posterior closing wedge osteotomy was efficient and relatively safe for treating thoracolumbar post-traumatic kyphosis, which do not require more than correction of the vertebral body kyphosis. On the contrary, due to adjacent disc damage, this technique did not fully restore regional lordosis at the lower lumbar spine, and lead to residual flatback deformity in spite of the same amout of vertebral kyphosis correction. This study points out the importance of the regional traumatic angulation as opposed to regional angulation for treating postraumatic kyphotic maulunion unsing closing wedge osteotomy, since physiological regional angulations are different between thoracolumbar junction and lower lumbar spine.