Department of Orthopaedic Surgery, Spine Center, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Spine (Phila Pa 1976). 2013 Jun 15;38(14):1238-43. doi: 10.1097/BRS.0b013e31828e0e56.
A retrospective study.
To describe the technique of a partial pedicle subtraction osteotomy (PPSO) and to report on the clinical and radiological outcomes.
Numerous corrective osteotomy techniques have been reported. Until now, there has been no reported method that can achieve a correction angle between those of the Smith-Petersen osteotomy and pedicle subtraction osteotomy as a posterior closing osteotomy that can be safely performed on the thoracic spine.
A total of 38 patients aged between 31 and 72 years, who underwent PPSO for spinal sagittal deformity correction were enrolled in this study. The mean postoperative follow-up period was 30.1 months (range, 24-36 mo). The assessments included the Oswestry Disability Index scores, immediate postoperative and 2-year postoperative correction angles, correction loss, pseudoarthrosis, and complications.
There were 6 patients who underwent PPSO alone and 32 patients who underwent PPSO combined with at least one other surgical procedure (PSO in 16 patients, anterior lumbar interbody fusion in 12 patients, and Smith-Petersen osteotomy in 4 patients). The level of the osteotomy was T10 in 6 patients, T11 in 15 patients, T12 in 10 patients, 1 in 4 patients, L2 in 2 patients, and L3 in 1 patient. There were significant improvements in the overall Oswestry Disability Index scores (P = 0.001). The mean postoperative correction angle immediately after the PPSO was 18.8° (range, 12.4°-26.1°) and the mean postoperative correction angle at 2 years was 18.4° (range, 11.9°-25.7°). There was no significant loss of correction found during the 2-year follow-up. There was also no pseudoarthrosis or neurological complications.
PPSO had resulted in intermediate correction rates between those of Smith-Petersen osteotomy and PSO. PPSO is considered to be a safe and reliable procedure for patients with spinal sagittal deformities even at the thoracic spine level.
回顾性研究。
描述部分脊柱椎弓根切除截骨术（PPSO）的技术，并报告其临床和影像学结果。
已经报道了许多矫正截骨技术。到目前为止，还没有报道过一种方法可以在胸段脊柱上安全地进行，作为一种后闭合截骨术，实现介于 Smith-Petersen 截骨术和脊柱椎弓根切除截骨术之间的矫正角度。
本研究共纳入 38 例年龄在 31 至 72 岁之间的患者，他们因脊柱矢状面畸形接受了 PPSO 矫正。平均术后随访时间为 30.1 个月（范围，24-36 个月）。评估包括 Oswestry 残疾指数评分、术后即刻和 2 年的矫正角度、矫正丢失、假关节和并发症。
6 例患者单独接受 PPSO，32 例患者接受 PPSO 联合至少一种其他手术（16 例患者接受 PSO，12 例患者接受前路腰椎间融合术，4 例患者接受 Smith-Petersen 截骨术）。截骨部位为 T10 者 6 例，T11 者 15 例，T12 者 10 例，L2 者 2 例，L3 者 1 例。总体 Oswestry 残疾指数评分有显著改善（P = 0.001）。PPSO 术后即刻的平均矫正角度为 18.8°（范围，12.4°-26.1°），术后 2 年的平均矫正角度为 18.4°（范围，11.9°-25.7°）。在 2 年的随访中，没有发现矫正丢失。也没有假关节或神经并发症。
PPSO 获得的矫正率介于 Smith-Petersen 截骨术和 PSO 之间。对于脊柱矢状面畸形患者，即使在胸段，PPSO 也是一种安全可靠的手术方法。
4 级。
