L5 pedicle subtraction osteotomy maintains good radiological and clinical outcomes in elderly patients with a rigid kyphosis deformity: a more than 2-year follow-up report.
Eur Spine J
; 29(12): 3018-3027, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-33025191
ABSTRACT
PURPOSE:
L5 pedicle subtraction osteotomy (PSO) is a demanding technique; thus, PSOs are usually performed at the L3/L4 level to correct the lack of lumbar lordosis. Mid- to long-term improvements in clinical outcomes after L5 PSO are unknown. We aimed to determine the efficacy and safety of L5 PSO for rigid kyphosis deformities.METHODS:
We retrospectively reviewed the records of 57 patients with a rigid kyphosis deformity (mean age 68 years) who underwent extensive corrective surgery incorporating PSO with a > 2-year follow-up. Radiographic parameters, postoperative complication rates, and the Oswestry Disability Index (ODI) scores were compared in the L5, L4, and L1-3 PSO groups preoperatively and at 1, 2, and 5 years postoperatively.RESULTS:
There were 12, 25, and 20 patients in the L5, L4, and L1-3 PSO groups, respectively. Significant between-group differences were found in preoperative L4-S1 lordosis (L5L4L1-3 PSO groups = - 8.9°8.9°16.2°, P < 0.001). The surgeries improved the postoperative spinopelvic alignment (similar in all groups). There was no significant between-group difference in the postoperative complication rate; no irreversible complications occurred. In the L5 PSO group, there was one case of a common iliac vein injury. The ODI scores improved postoperatively in all groups; this was maintained for 5 years postoperatively.CONCLUSION:
L5 PSO for L4-5/L5 kyphosis deformities resulted in adequate correction and ODI improvement, which were maintained up to 5 years postoperatively. The surgical invasiveness, complication rates, and long-term prognosis associated with L5 PSO were similar to those of PSOs performed at other levels.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cifosis
/
Vértebras Lumbares
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
Idioma:
En
Año:
2020
Tipo del documento:
Article