Pedicle subtraction osteotomy for repairing thoracolumbar degenerative kyphosis:correlation of spino-pelvic parameters / 中国组织工程研究

ABSTRACT

BACKGROUND:Thoracolumbar degenerative kyphosis could experience severe lumbar back pain due to sagittal plane imbalance, thereby affecting quality of life. Thus, it is very important to reconstruct spino-pelvic profile in these patients. OBJECTIVE:To explore the relationships between life quality and spino-pelvic parameters fol owing pedicle subtraction osteotomy for thoracolumbar degenerative kyphosis and the clinical significance. METHODS:Between May 2010 and October 2014, 59 patients with thoracolumbar degenerative kyphosis undergoing L2 pedicle subtraction osteotomy in Cangzhou Hospital of Integrated Traditional and Western Medicine were retrospectively reviewed. Anteroposterior and lateral X-ray films of al patients during standing were photographed before and after surgery. The pre-and post-operative thoracic kyphosis, lumbar lordosis, sagittal imbalance, T1 pelvic angle, pelvic incidence, sacral slope and pelvic tilt were measured in al patients. The patients’ quality of life was evaluated using SF-36 preoperatively and postoperatively. RESULTS AND CONCLUSION:(1) Significant differences were observed in the improvement of thoracic kyphosis, lumbar lordosis, pelvic tilt, sacral slope and sagittal imbalance (P<0.01). With respect to SF-36, postoperative SF-36 score was higher than preoperative postoperative SF-36 score (P<0.01). (2) The alteration of lumbar lordosis showed significant correlation with the change of pelvic tilt, sacral slope and sagittal imbalance. The change of pelvic tilt exhibited cardinal correlation with the change of sacral slope, body pain and general health. The improvement of sagittal imbalance significantly correlated with the improvement of lumbar lordosis, body pain and general health. The improvement of T1 pelvic angle significantly correlated with the improvement of lumbar lordosis, sagittal imbalance, body pain and general health. (3) Pedicle subtraction osteotomy can effectively restore spino-pelvic sagittal profile, improve the life quality and relieve pain for the patients with thoracolumbar degenerative kyphosis.