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Posterior Vertebral Column Resection in Management of Severe Post traumatic Thoracolumbar Kyphosis
Faculty
Medicine
Year:
2018
Type of Publication:
ZU Hosted
Pages:
Authors:
Shamel Ali Mohamed Ali Elgohary
Staff Zu Site
Abstract In Staff Site
Journal:
Egyptian spine Journal Egyptian spine Journal
Volume:
Keywords :
Posterior Vertebral Column Resection , Management , Severe
Abstract:
Thoracolumbar fractures nowadays are considered the commonest spinal fractures and its treatment remains one of the major controversies. Post-traumatic kyphosis (PTK) is considered the commonest serious complication of poorly managed thoracolumbar fractures which can affect the patient health quality of life. Different corrective osteotomy techniques are described to correct this deformity but with limited correction in sever angular kyphotic deformity. Our hypothesis was, among several osteotomies described to correct kyphosis, vertebral column resection (VCR) provides the highest angle of correction required to manage patients with severe PTK. Purpose: To evaluate the safety and efficacy of posterior VCR in the treatment of patients with severe degrees of post-traumatic thoracolumbar kyphosis and determine the degree of correction in sagittal imbalance and its relationship with functional outcome of the patients. Study Design: This prospective clinical case study. Patients and Methods: Twelve patients suffering from PTK and managed with posterior VCR were recruited for this study. The mean local kyphosis angle (LKA) was 64.1±6.3O . Outcome measures were Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) and radiological using local kyphosis angle (LKA), global kyphosis (GK), lumbar lordosis (LL) and sagittal vertical axis (SVA). The mean follow up time was 13.5±2 months. Results: The mean LKA and SVA score improved from 64.1± 6.3o and 52.6±8.3mm preoperatively to 8.8±3.4o and 13.1±4.8mm postoperatively, respectively. All were statistically significant. Functionally, the VAS score of back pain significantly reduced from 6.8±0.9 to 1.7±0.8 and the Oswestry Disability Index significantly improved from 59.8±7.5 to 11.6±3.4. No major complications were reported apart from intraoperative dural tear in 2 patients, superficial infection in one patient, deep infection in one patient and temporary paraparesis in one patient. Conclusion: Posterior VCR can provide satisfactory correction in severe PTK and improvement in functional outcome with appropriate application and fine surgical technique.
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Shamel Ali Mohamed Ali Elgohary, "A comparative study between anterior cervical discectomy with fusion and cervical total disc replacement for the treatment of cervical disc disease", Springer Verlag, 2012
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Shamel Ali Mohamed Ali Elgohary, "Clinical Results of Reconstruction of Bilateral Pathological Quadriceps Tendon Rupture in Chronic Renal Patients", The Egyptian Journal of Hospital Medicine, 2023
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Shamel Ali Mohamed Ali Elgohary, "Can Sacropelvic Fixation Improve Outcome of Long-Segment Lumbar Spine Fusion in Patients with Degenerative Lumbar Spine Disease", Egyptian spine Journal, 2020
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Shamel Ali Mohamed Ali Elgohary, "Transforaminal Lumbar Interbody Fusion versus Posterolateral Fusion for the Treatment of Low Grade Isthmic Spondylolisthesis in Adults", Egyptian orthopaedic Journal, 2021
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