Berven S H, Deviren V, Smith J A, Emami A, Hu S S, Bradford D S
Department of Orthopaedic Surgery, University of California, San Francisco, California, USA.
Spine (Phila Pa 1976). 2001 Sep 15;26(18):2036-43. doi: 10.1097/00007632-200109150-00020.
Retrospective review of a consecutive clinical series.
To evaluate the efficacy of the transpedicular wedge resection osteotomy as a technique for correction of sagittal and coronal deformity and to assess the clinical value of the procedure as assessed by patient satisfaction.
The transpedicular wedge resection osteotomy is a well-established procedure for management of fixed sagittal deformity in ankylosing spondylitis. The utility of the procedure for applications in fixed deformity other than ankylosing spondylitis has not been demonstrated, and the efficacy of the procedure in the correction of coronal deformity has not been reported.
A total of 13 consecutive cases undergoing transpedicular wedge resection osteotomy for the management of sagittal deformity of any etiology were reviewed. Radiographic studies, complications, and satisfaction assessment using the modified Scoliosis Research Society instrument were the outcome parameters measured.
Etiologies of deformity included postsurgical, ankylosing spondylitis, idiopathic, and infectious. Measurement of C7 sagittal plumb line to sacrum improved 63% at the most recent follow-up. Lumbar lordosis increased from -15.5 degrees to -45.4 degrees. Coronal balance was improved in all patients who had preoperative imbalance, with an average improvement of 60% maintained at follow-up. Patient satisfaction was high in all patients and not dependent on the etiology of deformity.
The transpedicular wedge resection osteotomy is an effective procedure for the management of fixed sagittal deformity and is generalizable for multiple etiologies. Simultaneous correction of coronal deformity is possible. The clinical value of the procedure is demonstrated in high rates of patient satisfaction.
对连续临床病例系列进行回顾性研究。
评估经椎弓根楔形截骨术矫正矢状面和冠状面畸形的疗效，并通过患者满意度评估该手术的临床价值。
经椎弓根楔形截骨术是治疗强直性脊柱炎固定性矢状面畸形的成熟手术。该手术在治疗除强直性脊柱炎以外的其他固定性畸形中的应用价值尚未得到证实，且其矫正冠状面畸形的疗效也未见报道。
回顾了连续13例因各种病因导致矢状面畸形而接受经椎弓根楔形截骨术的病例。测量指标包括影像学检查、并发症以及使用改良的脊柱侧凸研究学会工具进行的满意度评估。
畸形病因包括术后、强直性脊柱炎、特发性和感染性。在最近一次随访时，C7矢状垂直线至骶骨的测量值改善了63%。腰椎前凸从-15.5度增加到-45.4度。所有术前存在冠状面失衡的患者，其冠状面平衡均得到改善，随访时平均改善率维持在60%。所有患者的满意度都很高，且不依赖于畸形的病因。
经椎弓根楔形截骨术是治疗固定性矢状面畸形的有效方法，可推广应用于多种病因。同时矫正冠状面畸形也是可行的。该手术的临床价值体现在患者的高满意度上。
