International Journal of Neurosurgery

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Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report

Received: 11 September 2023    Accepted: 9 October 2023    Published: 31 October 2023
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Abstract

Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.

DOI 10.11648/j.ijn.20230702.14
Published in International Journal of Neurosurgery (Volume 7, Issue 2, December 2023)
Page(s) 36-40
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Kyphosis, Pedicle Subtraction Osteotomy, Deformed Compound Vertebra, Sagittal Balance, Case Report

References
[1] YAMAN O, DALBAYRAK S. Kyphosis: Diagnosis, classification and treatment methods [J]. Turkish Neurosurgery, 2014, 24(1).
[2] BUCHOWSKI J M, KUHNS C A, BRIDWELL K H, et al. Surgical management of posttraumatic thoracolumbar kyphosis [J]. Spine J, 2008, 8(4): 666-77.
[3] VACCARO A R, SILBER J S. Post-traumatic spinal deformity [J]. Spine (Phila Pa 1976), 2001, 26(24 Suppl): S111-8.
[4] SONG K S, CHANG B S, YEOM J S, et al. Surgical treatment of severe angular kyphosis with myelopathy: anterior and posterior approach with pedicle screw instrumentation [J]. Spine (Phila Pa 1976), 2008, 33(11): 1229-35.
[5] ZHANG H Q, XIAO L G, GUO C F, et al. Deformed Complex Vertebral Osteotomy Technique for Management of Severe Congenital Spinal Angular Kyphotic Deformity [J]. Orthop Surg, 2021, 13(3): 1016-25.
[6] SAR C, ERALP L. Three-stage surgery in the management of severe rigid angular kyphosis [J]. Eur Spine J, 2002, 11(2): 107-14.
[7] ZHANG H Q, DENG A, GUO C F, et al. Retrospective analysis of deformed complex vertebral osteotomy in children with severe thoracic post-tubercular angular kyphosis [J]. BMC Musculoskelet Disord, 2022, 23(1): 805.
[8] WANG S, AIKENMU K, ZHANG J, et al. The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis [J]. Eur Spine J, 2017, 26(7): 1817-25.
[9] BURTON D C. Smith-Petersen osteotomy of the spine [J]. Instr Course Lect, 2006, 55: 577-82.
[10] CHO K J, BRIDWELL K H, LENKE L G, et al. Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance [J]. Spine (Phila Pa 1976), 2005, 30(18): 2030-7; discussion 8.
[11] HU X, THAPA A J, CAI Z, et al. Comparison of smith-petersen osteotomy, pedicular subtraction osteotomy, and poly-segmental wedge osteotomy in treating rigid thoracolumbar kyphotic deformity in ankylosing spondylitis a systematic review and meta-analysis [J]. BMC Surg, 2016, 16: 4.
[12] PARK J S, KIM J, JOO I H, et al. Analysis of risk factors for sagittal translation after pedicle subtraction osteotomy in patients with ankylosing spondylitis [J]. Spine J, 2018, 18(8): 1356-62.
[13] RILEY M S, LENKE L G, CHAPMAN T M, JR., et al. Clinical and Radiographic Outcomes After Posterior Vertebral Column Resection for Severe Spinal Deformity with Five-Year Follow-up [J]. J Bone Joint Surg Am, 2018, 100(5): 396-405.
[14] SCHWAB F, BLONDEL B, CHAY E, et al. The comprehensive anatomical spinal osteotomy classification [J]. Neurosurgery, 2014, 74(1): 112-20; discussion 20.
[15] YANG C, ZHENG Z, LIU H, et al. Posterior vertebral column resection in spinal deformity: a systematic review [J]. Eur Spine J, 2016, 25(8): 2368-75.
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  • APA Style

    Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, et al. (2023). Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. International Journal of Neurosurgery, 7(2), 36-40. https://doi.org/10.11648/j.ijn.20230702.14

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    ACS Style

    Shuchi Lv; Jianyu Zou; Guowei Zhang; Hua Yang; Zhisheng Ji, et al. Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. Int. J. Neurosurg. 2023, 7(2), 36-40. doi: 10.11648/j.ijn.20230702.14

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    AMA Style

    Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, et al. Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. Int J Neurosurg. 2023;7(2):36-40. doi: 10.11648/j.ijn.20230702.14

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  • @article{10.11648/j.ijn.20230702.14,
      author = {Shuchi Lv and Jianyu Zou and Guowei Zhang and Hua Yang and Zhisheng Ji and Hongsheng Lin},
      title = {Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report},
      journal = {International Journal of Neurosurgery},
      volume = {7},
      number = {2},
      pages = {36-40},
      doi = {10.11648/j.ijn.20230702.14},
      url = {https://doi.org/10.11648/j.ijn.20230702.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20230702.14},
      abstract = {Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.
    },
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report
    AU  - Shuchi Lv
    AU  - Jianyu Zou
    AU  - Guowei Zhang
    AU  - Hua Yang
    AU  - Zhisheng Ji
    AU  - Hongsheng Lin
    Y1  - 2023/10/31
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ijn.20230702.14
    DO  - 10.11648/j.ijn.20230702.14
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 36
    EP  - 40
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20230702.14
    AB  - Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.
    
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

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