Titre du document / Document title

Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance

Auteur(s) / Author(s)

BRIDWELL Keith H. ⁽¹⁾ ; LEWIS Stephen J. ⁽¹⁾ ; EDWARDS Charles ⁽¹⁾ ; LENKE Lawrence G. ⁽¹⁾ ; IFFRIG Theresa M. ⁽¹⁾ ; BERRA Annette ⁽¹⁾ ; BALDUS Christine ⁽¹⁾ ; BLANKE Kathy ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO 63110, ETATS-UNIS

Résumé / Abstract

Study Design. Radiographic analysis, outcomes analysis (pain scale, Oswestry, SRS-24), and accumulation of complications. Outcomes and complications collected prospectively. Radiographic analysis performed retrospectively. Objectives. To assess the benefits and stress complications of pedicle subtractions osteotomies for patients with fixed sagittal imbalance. of Background Data. Few reports on pedicle subtraction osteotomies exist in the peer review literature for conditions other than trauma and ankylosing spondylitis. Materials and Methods. Thirth-three consecutive patients with sagittal imbalance treated with lumbar pedicle-subtraction osteotomy at one institution (minimum 2-year follow-up) were analyzed. Complications were also analyzed for the entire group of consecutive pedicle subtraction osteotomies done at out institution to date (n = 66). Results. For the 33 patients with minimum 2-year follow-up, there were significant improvements in the overall Oswestry score (P 0.0001) and pain score (P = 0.0001). Most patients reported improvement in pain and self-imaged and reported overall satisfaction based on ultimate SRS-24 questionnaire. There was one pseudarthrosis in the lumbar spine through an area of pedicle subtraction osteotomy (area of previous laminectomy and nonunion), and six patients had thoracic pseudarthroses (levels other than the osteotomy level) and one patient had a pseudarthrosis at LS-S1. Two patients had acute angular kyphosis at the thoracolumbar jonction at the proximal end of the construct. Five patients who experienced transient neurologic deficits resolved their deficits after central canal enlargement. Conclusions. The clinical result with pedicle subtraction osteotomy is reduced with pseudarthrosis in the thoracic or lumbar spine and subsequent breakdown adjacent to the fusion. For patients with a degenerative sagittal imbalance etiology the results were worse and the complications were higher. Central canal enlargement is critical.

Revue / Journal Title

Spine   ISSN 0362-2436   CODEN SPINDD 

Source / Source

2003, vol. 28, n^o18, pp. 2093-2101 [9 page(s) (article)] (25 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott, Hagerstown, MD, ETATS-UNIS  (1976) (Revue)

Mots-clés anglais / English Keywords

Surgery ; Human ; Prognosis ; Complication ; Technique ; Osteotomy ;

Mots-clés français / French Keywords

Chirurgie ; Homme ; Pronostic ; Complication ; Technique ; Ostéotomie ;

Mots-clés espagnols / Spanish Keywords

Cirugía ; Hombre ; Pronóstico ; Complicación ; Técnica ; Osteotomía ;

Mots-clés d'auteur / Author Keywords

fixed sagittal imbalance ; pedicle subtraction osteoteomy ; complications ;

Localisation / Location

INIST-CNRS, Cote INIST : 18922, 35400011312023.0070