Spinal wedge osteotomy by a single posterior approach for correction of severe post-adolescent congenital spinal deformities / 中国矫形外科杂志

ABSTRACT

[Objective]To introduce the safety of the spinal wedge osteotomy by a single posterior approach and to discuss the selection of fusion and fixation. [Method]Sixteen patients with severe post-adolescent congenital spinal deformities were treated by spinal wedge osteotomy by a single posterior approach from February 2000 and July 2006.There were 10 males and 6 females with an average age of 21.4 years(range 16 to 29 years).There were 11 patients with hemivertebre and 5 with fused ribs or bone bridge.Two patients had previous surgery history.The average Cobb's angles of scoliosis and kyphosis before operation were 84.7 ?and 52.6?.The average trunk shift was 15.4 mm.Bony septum in the canal was found in 2 patients on the preoperative CT or MRI.[Result]The follow-up ranged from 2 to 4 years with an average of 2 years and six months.The average fused vertebrae were 10.6 segments(range 8 to 14 segments).The postoperative average Cobb's angles of scoliosis and kyphosis were 38.5 and 27.7.The average correction rates of scoliosis and kyphosis were 54.5% and 47.4%.The average trunk shift was improved to 4.6 mm.There was no significant correction loss of the scoliosis,kyphosis and trunk shift at final follow-up evaluation.No patient developed severe complications except that two had pedicle fracture,one had L1 nerve root injury,one had superior mesenteric artery syndrome and one had exudates of incision.[Conclusion]Spinal wedge osteotomy by the single posterior approach is a reliable and safe surgical technique for correcting severe post-adolescent congenital spinal deformities.