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Published on: November 8, 2024
Trans-intervertebral space osteotomy for post-traumatic thoracolumbar kyphosis: a minimum 2-year follow-up study
Yu-Liang Sun1, Tao Gu1, Xuan-Geng Deng1
1Sichuan Provincial Orthopedics Hospital, Chengdu, China.
Background:
This study aims to evaluate the radiographic results and clinical efficacy of trans-intervertebral space osteotomy (TIO) in the treatment of post-traumatic thoracolumbar kyphosis (PTK).
Study Design/Setting:
This is a single-center retrospective cohort study.
Methods:
A retrospective analysis was conducted on clinical data from PTK patients who underwent TIO between January 2018 and December 2022. A total of 38 patients (18 males and 20 females) with an average age of 52.1 ± 9.2 years were included. According to the Frankel classification, 8 cases were grade D and 30 cases were grade E. Spinal-pelvic sagittal parameters (thoracic kyphosis [TK], thoracolumbar kyphosis [TLK], lumbar lordosis [LL], focal kyphosis [FK], pelvic incidence [PI], pelvic tilt [PT], sacral slope [SS], sagittal vertical axis [SVA]) were measured on lateral spinal X-rays preoperatively, postoperatively, and at the last follow-up. The Visual Analog Score (VAS) and Oswestry Disability Index (ODI) were recorded postoperatively and at the last follow-up, and perioperative/follow-up complications were documented.
Results:
The average operation time was 277.4 ± 33.9 min, with an average intraoperative blood loss of 704.5 ± 340.5 mL. All incisions achieved primary healing. The mean follow-up period was 35.1 ± 9.4 months (range: 24-56 months). Postoperatively, TK, TLK, LL, FK, and SVA were significantly improved (p < 0.05), while PT, PI, and SS showed no significant changes (p > 0.05). These radiographic outcomes remained stable at the last follow-up (p > 0.05). The preoperative VAS score (6.0 ± 1.1) decreased significantly to 1.2 ± 0.8 at the last follow-up (p < 0.05), and the preoperative ODI (56.9 ± 7.1%) was reduced to 15.7 ± 3.9% (p < 0.05). At the final follow-up, the Frankel classification showed 3 cases of grade D and 35 cases of grade E. All fixed segments achieved fusion, with no internal fixation loosening or adjacent vertebral fractures.
Conclusion:
TIO for PTK patients achieves satisfactory correction of spinal deformity and favorable clinical outcomes, with successful fusion and few complications.
