Acta Orthopaedica et Traumatologica Turcica

Results of closing wedge osteotomy in the treatment of sagittal imbalance due to ankylosing spondylitis

AOTT 2016; 50: 63-68
DOI: 10.3944/AOTT.2016.14.0059
Read: 668 Downloads: 312 Published: 07 February 2020
Abstract

Objective: Ankylosing spondylitis is a systemic disease which affects the axial skeleton and may cause rigid spinal deformities in advanced cases. Clinical and radiological results of patients with ankylosing spondylitis who underwent pedicle subtraction osteotomy (PSO) were evaluated.
Methods: Twelve (3 female, 9 male) patients who were treated for rigid spinal deformities due to ankylosing spondylitis were evaluated. All patients were treated with the same surgical technique, which included PSO and pedicle screw-rod combination. For radiological results, thoracic kyphosis, lumbar lordosis, pelvic parameters (pelvic incidence, sacral inclination, pelvic tilt), and the distance between the central sagittal line (CSVL) and the sacrum were measured from pre- and postoperative radiograms. For functional results, SF-36 and Oswestry Disability Index (ODI) were used.
Results: Mean age of the patients was 39.8±8.4 years, and mean follow-up was 85.6±39.1 months. Mean angle of lordosis was improved from 6.6°±13.7° preoperatively to 43.8°±8.4° postoperatively (p<0.0001). Mean CSVL was improved from 19.7±9.7 cm preoperatively to 7.45±3.8 cm postoperatively (p=0.0005). Mean local angular change around the osteotomy site was 30.2°±6.2°. The pelvic parameters were not significantly changed after the surgeries. Mean ODI, SF-36 mental, and SF-36 physical scores were 30.16±9.7, 41.2±9.9 and 35.3±7.1, respectively.
Conclusion: In patients with rigid sagittal spinal deformities due to ankylosing spondylitis, lumbar lordosis and sagittal balance can be obtained using PSO.

Özet

Objective: Ankylosing spondylitis is a systemic disease which effects axial skeleton and may cause rigid spinal deformities in advanced cases. Clinical and radiological results of the patients with ankylosing spondylitis who underwent pedicle subtraction osteotomy (PSO) were evaluated.

Patients and methods: Twelve (Three female and nine male) patients who were treated for rigid spinal deformities due to ankylosing spondylitis were evaluated. All patients were treated with the same surgical technique, which includes PSO and pedicle screw-rod combination. For the radiological results, thoracic kyphosis, lumbar lordosis, pelvic parameters (Pelvic incidence, sacral inclination and pelvic tilt) and the distance between the central sagittal line (CSVL) and the sacrum were measured on the preoperative and postoperative radiograms. For the functional results SF-36 and Oswestry Disability Index (ODI) were used.

Results: The mean age of the patients was 39.8±8.4 years and the mean follow-up was 85.6±39.1 months. The mean angle of lordosis was improved from 6.6°±13.7° preoperatively to 43.8°±8.4° postoperatively (p<0.0001). The mean CSVL was improved from 19.7±9.7 cm preoperatively to 7.45±3.8 cm postoperatively (p=0.0005). The mean local angular change around the osteotomy site was 30.2°±6.2°. The pelvic parameters were not significantly changed after the surgeries. The mean ODI, SF-36 mental and SF-36 physical scores were 30.16±9.7, 41.2±9.9 and 35.3±7.1, respectively.

Conclusion: In patients with rigid sagittal spinal deformities due to ankylosing spondylitis, lumbar lordosis and sagittal balance can be obtained using PSO.

 

DOI: 10.3944/AOTT.2015.14.0059
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

 

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ISSN 1017-995X EISSN 2589-1294