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European Spine Journal
Published in: European Spine Journal 1/2015

01-01-2015 | Original Article

Pedicle subtraction osteotomy in the thoracic spine and thoracolumbar junction: a retrospective series of 28 cases

Authors: A. Faundez, F. Byrne, C. Sylvestre, V. Lafage, A. Cogniet, Jean-Charles Le Huec

Published in: European Spine Journal | Special Issue 1/2015

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Abstract

Purpose

Pedicle subtraction osteotomy is a well-described surgical technique for treatment of kyphotic deformity in the spine. It is not widely used for treatment of thoracic kyphosis. We present the first documented series of 28 patients who underwent this procedure in 3 international centers. These patients presented with severe deformity with a wide range of aetiologies.

Indications

Kyphosis larger than 70 degrees, which is demonstrably rigid based on dynamic imaging.

Materials and methods

28 patients underwent surgery following pre-op neurological and radiographic assessment to fully assess the deformity. A triangular osteotomy was carried out using intraoperative navigation techniques. The patients were assessed post-operatively again with clinical and radiographic parameters at regular follow-up.

Results

The mean ODI score after surgery was 24.7 (16–42) while the pre-op was 53.4 (38–76). Mean thoracic kyphosis was improved from 64.2° (±20.1°) to 41.1° (±17.4°) resulting in a mean sagittal correction of 23.1°. Mean segmental correction at the PSO for all 28 cases was 17.8° (±8.1°). Stratified by region we found different values for the PSO correction: between T1 and T5 (6 cases) it was 17.5° (±5.4°) and between T6 and T9 (4 cases) 18.2° (±4.7°) and between T10 and L1 (18 cases) 26.2° (±5.2°). FBI index was 22.3° pre-op and improved to 7.8° post-op. Calculations were performed with Microsoft excel (2011 Microsoft, Redmond, WA).

Conclusions

Global sagittal balance was statistically improved in this series as demonstrated by FBI and C7 SVA correction.
Literature
1.
Barrey C et al (2013) Compensatory mechanisms contributing to keep the sagittal balance of the spine. Eur Spine J 22(Suppl 6):S834–S841PubMedCrossRef
2.
O’Shaughnessy BA, Kuklo TR, Hsieh PC, Yang BP, Koski TR, Ondra SL (2009) Thoracic pedicle subtraction osteotomy for fixed sagittal spinal deformity. Spine (Phila Pa 1976) 34:2893–2899CrossRef
3.
Lewis SJ, Goldstein S, Bodrogi A, Dear T, Keshen SG, Shihata S, Lewis ND, Magana S (2014) Comparison of pedicle subtraction and Smith-Petersen osteotomies in correcting thoracic kyphosis when closed with a central hook-rod construct. Spine (Phila Pa 1976) 39:1217–1224CrossRef
4.
Zeng Y, Chen Z, Guo Z, Qi Q, Li W, Sun C (2014) The posterior surgical treatment for focal kyphosis in upper-middle thoracic spine. Eur Spine J 23(11):2291–2298PubMedCrossRef
5.
Gill JB, Levin A, Burd T, Longley M (2008) Corrective osteotomies in spine surgery. J Bone Joint Surg Am 90:2509–2520PubMedCrossRef
6.
Hayashi Y, Kushida K, Kitazawa A et al (1998) Measurement of vertebral body dimensions of the thoracic and lumbar spines of 242 healthy women. J Bone Miner Metab 16:27–33CrossRef
7.
Kim YJ, Bridwell KH, Lenke LG, Cheh G, Baldus C (2007) Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study. Spine (Phila Pa 1976) 32:2189–2197CrossRef
8.
Mazda K, Ilharreborde B, Even J, Lefevre Y, Fitoussi F, Pennecot GF (2009) Efficacy and safety of posteromedial translation for correction of thoracic curves in adolescent idiopathic scoliosis using a new connection to the spine: the Universal Clamp. Eur Spine J 18:158–169PubMedCentralPubMedCrossRef
9.
Bridwell KH et al (2003) Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine (Phila Pa 1976) 28(18):2093–2101CrossRef
10.
Yang BP, Ondra SL, Chen LA, Jung HS, Koski TR, Salehi SA (2006) Clinical and radiographic outcomes of thoracic and lumbar pedicle subtraction osteotomy for fixed sagittal imbalance. J Neurosurg Spine 5:9–17PubMedCrossRef
11.
Dubousset J et al (2007) EOS stereo-radiography system: whole-body simultaneous anteroposterior and lateral radiographs with very low radiation dose. Rev Chir Orthop Reparatrice Appar Mot 93(6 Suppl):141–143PubMedCrossRef
12.
Le Huec JC et al (2011) Thoracolumbar imbalance analysis for osteotomy planification using a new method: FBI technique. Eur Spine J 20(Suppl 5):669–680PubMedCentralPubMedCrossRef
Metadata
Title
Pedicle subtraction osteotomy in the thoracic spine and thoracolumbar junction: a retrospective series of 28 cases
Authors
A. Faundez
F. Byrne
C. Sylvestre
V. Lafage
A. Cogniet
Jean-Charles Le Huec
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 1/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3658-3

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