Tsai Shang-Hsuan, Liang Che-Han, Chen Kun-Hui, Pan Chien-Chou, Lu Wen-Hsien, Lee Cheng-Hung
Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan;Department of Orthopedic Surgery, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
Acta Orthop Traumatol Turc. 2020 Mar;54(2):144-148. doi: 10.5152/j.aott.2020.02.354.
This study aimed to assess the efficacy and safety of a newly developed transpedicular, anterior open-wedge osteotomy procedure with lamina preservation to correct sagittal imbalance in regional kyphotic deformities following compression fractures.
All seven patients [four females and three males; mean (range) age, 67 (56-78) years] included in this study underwent surgery between May 2005 and May 2016 for symptomatic, rigid kyphosis secondary to compression fractures. Transpedicular, anterior open-wedge osteotomy with lamina preservation was performed in all patients using an osteotome to create a transverse fracture in the vertebral body through bilateral pedicles and an anterior open-wedge space filled with compacted bone graft to correct kyphosis. Pre- and post-operative kyphotic Cobb angles were evaluated, and the volume of intra-operative blood loss was measured.
The pre- and post-operative kyphotic Cobb angle was 35.3° and 17.7°, respectively (p<0.01); mean angle correction was 17.6° (p<0.05). No patient developed any complication with neurologic injury. Mean blood loss was 771 mL. Callus formation viewed on plain film was evident in all patients and was accompanied by decreased thoracolumbar back pain.
Transpedicular, anterior open-wedge osteotomy with lamina preservation is an easy and safe spinal osteotomy procedure for the correction of regional, fixed kyphotic deformities.
Level IV, Therapeutic study.
本研究旨在评估一种新开发的保留椎板的经椎弓根前路开放楔形截骨术治疗压缩性骨折后区域性后凸畸形矢状面失衡的有效性和安全性。
本研究纳入的7例患者（4例女性，3例男性；平均年龄67岁，范围56 - 78岁）于2005年5月至2016年5月因症状性、僵硬性压缩性骨折继发后凸畸形接受手术。所有患者均采用保留椎板的经椎弓根前路开放楔形截骨术，使用骨刀通过双侧椎弓根在椎体上制造横向骨折，并在前路开放楔形间隙填充压实的骨移植材料以矫正后凸畸形。评估术前和术后的后凸Cobb角，并测量术中失血量。
术前和术后的后凸Cobb角分别为35.3°和17.7°（p<0.01）；平均角度矫正为17.6°（p<0.05）。无患者发生神经损伤并发症。平均失血量为771 mL。所有患者X线平片上均可见骨痂形成，并伴有胸腰背部疼痛减轻。
保留椎板的经椎弓根前路开放楔形截骨术是一种简单、安全的脊柱截骨术，用于矫正区域性、固定性后凸畸形。
IV级，治疗性研究。
