ATYPICAL SEGMENTAL CORRECTIVE VERTEBRECTOMY IN THE TREATMENT OF POST-TRAUMATIC THORACIC KYPHOSIS
https://doi.org/10.14531/ss2014.4.20-24
Abstract
Objective. To analyze results of atypical segmental corrective vertebrectomy in patients with painful thoracic kyphosis treated in the late period of spinal cord injury.
Material and Methods. Eight patients with painful kyphotic and shear deformities were operated on during 2012. The method of atypical segmental corrective vertebrectomy was used. Average kyphotic deformity was 43.1° ± 15.0°, the rate of anterior shear displacement varied from 25 to 48 %.
Results. The average kyphosis correction was 9.1° ± 5.8° with complete correction of shear deformity. Questionnaire data showed the decrease in pain score from 4.4 ± 1.8 to 2.6 ± 1.6 on VAS, and improvement in functional capacity from 74.4 ± 12.0 to 83.5 ± 9.0 on FIM (Functional Independence Measure) in the follow-up period.
Conclusion. Atypical corrective segmental vertebrectomy performed in the late period of spinal cord injury effectively eliminates post-traumatic deformity, and improves functional capacity of patients with complete neurological deficit.
About the Authors
Viktor Viktorovich Rerikh
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan; Novosibirsk State Medical University
Russian Federation
Russian Federation
Konstantin Olegovich Borzykh
Novisibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
Shukhrat Numonzhonovich Rakhmatillaev
Novisibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
References
1. Бывальцев В.А., Белых В.А., Сороковиков В.А. и др. Использование шкал и анкет в вертебрологии // Журнал неврологии и психиатрии. 2011. № 9. С. 51-56. [Byval’tsev VA, Belyh VA, Sorokovikov VA, et al. The use of scales and questionnaires in vertebrology. Zh Nevrol Psikhiat Im SS Korsakova. 2011; (9): 51-56. In Russian].
2. Виссарионов С.В., Дроздецкий А.П., Кокушин Д.Н. и др. Оперативное лечение пациентки с переломовывихом в грудном отделе позвоночника // Хирургия позвоночника. 2011. № 3. С.21-25. [Vissarionov SV, Drozdetsky AP, Kokushin DN, et al. Surgical treatment of a patient with fracture-dislocation in the thoracic spine. Hir pozvonoc. 2011; (3): 21-25. In Russian].
3. Рябых С.О., Прудникова О.Г., Савин Д.М. Укорачивающая вертебротомия у пациента с тяжелой позвоночно-спинномозговой травмой // Гений ортопедии. 2012. № 4. С. 128-130. [Ryabykh SO, Prudnikova OG, Savin DM. Shortening vertebrotomy in a patient with severe spine-and-spinal cord injury. Geniy ortopedii. 2012; (4): 128-130. In Russian].
4. Been HD, Bouma GJ. Comparison of two types of surgery for thoraco-lumbar burst fractures: combined anterior and posterior stabilization vs. posterior instrumentation only. Acta Neurochir (Wien). 1999; 141: 349-357.
5. Bridwell KH, Lewis SJ, Lenke LG, et al. Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am. 2003; 85: 454-463.
6. Buchowski JM, Kuhns CA, Bridwell KH, et al. Surgical management of posttraumatic thoracolumbar kyphosis. Spine J. 2008; 8: 666-677.
7. Chang KW, Chen YY, Lin CC, et al. Apical lordosating osteotomy and minimal segment fixation for the treatment of thoracic or thoracolumbar osteoporotic kyphosis. Spine 2005; 30: 1674-1681.
8. Chang KW, Cheng CW, Chen HC, et al. Closing-opening wedge osteotomy for the treatment of sagittal imbalance. Spine. 2008; 33: 1470-7. doi: 10.1097/BRS.0b013e3181753bcd.
9. Kuklo TR, Polly DW, Owens BD, et al. Measurement of thoracic and lumbar fracture kyphosis: evaluation of intraobserver, interobserver, and technique variability. Spine. 2001; 26: 61-66.
10. Magerl F, Aebi M, Gertzbein S, et al. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J. 1994; 3: 184-201.
11. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004; 32: 470-485.
12. Suk SI, Kim JH, Lee SM, et al. Anterior-posterior surgery versus posterior closing wedge osteotomy in posttraumatic kyphosis with neurologic compromised osteoporotic fracture. Spine. 2003; 28: 2170-2175.
13. Shimode M, Kojima T, Sowa K. Spinal wedge osteotomy by a single posterior approach for correction of severe and rigid kyphosis or kyphoscoliosis. Spine. 2002; 27: 2260-2267.
Review
For citations:
Rerikh V.V., Borzykh K.O., Rakhmatillaev Sh.N. ATYPICAL SEGMENTAL CORRECTIVE VERTEBRECTOMY IN THE TREATMENT OF POST-TRAUMATIC THORACIC KYPHOSIS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2014;(4):20-24. (In Russ.) https://doi.org/10.14531/ss2014.4.20-24
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