Introduction/Aim. In rigid Sagittal and Coronal deformities of the spine Pedicle Subtraction Osteotomies (PSO) is preferred to achieve maximal correction. We describe successful Asymmetrical Pedicle Subtraction Osteotomies (APSO) performed on patients with symptomatic coronal imbalance. Methods/Results. Case 1: 28yr old female with VATER syndrome with 25° coronal imbalance to her left with past h/o fusion from L3 – S1 for L5 hemi-vertebra. After APSO at L3 coronal imbalance was reduced to 0°. Case 2: 49yr old male with post-traumatic coronal deformity of 35° at T6 and paraplegia affecting his sitting balance and respiratory function. Following APSO at T12 imbalance was reduced to 5°. Osteotomy Technique. After insertion of pedicle screws for the stabilisation, laminectomy of the proposed
The aim of this study is to introduce and investigate the efficacy
and feasibility of a new vertebral osteotomy technique, vertebral
column decancellation (VCD), for rigid thoracolumbar kyphotic deformity
(TLKD) secondary to ankylosing spondylitis (AS). We took 39 patients from between January 2009 and January 2013
(26 male, 13 female, mean age 37.4 years, 28 to 54) with AS and
a TLKD who underwent VCD (VCD group) and compared their outcome
with 45 patients (31 male, 14 female, mean age 34.8 years, 23 to
47) with AS and TLKD, who underwent pedicle subtraction osteotomy
(PSO group), according to the same selection criteria. The technique
of VCD was performed at single vertebral level in the thoracolumbar
region of AS patients according to classification of AS kyphotic
deformity. Pre- and post-operative chin-brow vertical angle (CBVA),
sagittal vertical axis (SVA) and sagittal Cobb angle in the thoracolumbar
region were reviewed in the VCD and PSO groups. Intra- , post-operative
and general complications were analysed in both group.Aims
Patients and Methods
We studied 15 patients with healed tuberculosis of the spine and a resultant kyphosis. We selected only those with no neurological deficit and performed a wedge resection of the vertebra using a transpedicular approach. The wedge was removed from the apex of the deformity. For those with a neurological deficit, we chose the conventional anterior debridement and decompression with 360° circumferential fusion. At a mean follow-up of 26.8 months (8 to 46) the outcome was good with an increase in the mean Oswestry Disability Index from 56.26 (48 to 62) pre-operatively to 11.2 (6 to 16) at the latest follow-up.
