Comparison of 2 Surgeries in Correction of Severe Kyphotic Deformity Caused by Ankylosing Spondylitis: Vertebral Column Decancellation and Pedicle Subtraction Osteotomy.

Abstract:

OBJECTIVE:To compare the treatment results between 1-level vertebral column decancellation (VCD) and pedicle subtraction osteotomy (PSO) for correcting severe kyphotic deformity in ankylosing spondylitis (AS). VCD and PSO have been used to correct AS-related kyphotic deformity, but the differences on correcting results between VCD and PSO are not clear. METHODS:Between 2013 and 2015, 57 patients underwent 1-level spinal osteotomy (VCD: n = 30; PSO: n = 27) for correcting kyphotic deformity. Sagittal parameters, fusion results, surgical information, and clinical outcomes were documented and compared. All data were obtained before and 1 week after surgery, 6 months after surgery, and at final follow-up (at least 2 years). RESULTS:VCD provided significantly greater osteotomy angle (50.8° ± 9.7°) than PSO (38.5° ± 6.1°). In the VCD group, the change of the anterior column was 5.0 ± 1.3 mm, which was larger than the PSO group. The middle column was shortened by 9.9 ± 2.0 mm and 19.1 ± 3.3 mm in the VCD group and PSO group, respectively. There was no significant difference in operating time and blood loss between the 2 groups. All cases had solid fusion. Between the 2 groups, Scoliosis Research Society Outcomes Instrument-22 scores were similar at the final follow-up. No major acute complications occurred in both groups. CONCLUSIONS:VCD is a safe and effective method in treating rigid kyphotic deformity secondary to AS. VCD provides a larger correction angle in one segment and preserves more height of osteotomized vertebrae than PSO.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Wang T,Zheng G,Wang Y,Zhang X,Hu F,Wang Y

doi

10.1016/j.wneu.2019.04.011

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

e972-e978

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)31002-2

journal_volume

127

pub_type

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