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Closing-opening wedge osteotomy to correct angular kyphotic deformity by a single posterior approach
1Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan. seikei@kenroku.ipc.kanazawa-u.ac-jp
Spine
|February 27, 2001
Summary
Closing-opening wedge osteotomy effectively corrects angular kyphosis with no neurologic complications. This posterior spinal surgery achieves significant kyphosis reduction and maintains fusion long-term.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Surgical techniques
Background:
- Correction osteotomy for severe kyphosis is challenging.
- Traditional two-stage operations involve anterior release and posterior fusion.
- A novel single-stage posterior approach is investigated.
Purpose of the Study:
- To evaluate the safety and efficacy of closing-opening wedge osteotomy for treating angular kyphosis.
- To assess the technique's ability to correct spinal deformity.
- To determine the complication rate associated with the procedure.
Main Methods:
- Seven patients with thoracic or thoracolumbar angular kyphosis underwent closing-opening wedge osteotomy via a single posterior approach.
- The technique involves initial closing wedge osteotomy for decompression, followed by opening wedge osteotomy for correction.
- Posterior instrumentation and grafting were used for stabilization.
Main Results:
- Average kyphosis reduced from 67 to 18 degrees.
- Physiologic sagittal alignment was restored.
- No neurologic complications occurred, and bony fusion was achieved in all patients with no loss of correction.
Conclusions:
- Closing-opening wedge osteotomy provides safe and satisfactory correction of angular kyphosis.
- Direct visualization during decompression of the spinal cord ensures safety.
- Despite being technically demanding, the procedure offers good correction without compromising spinal cord integrity.