ABSTRACT

Introduction:

This is clinical study of adult patients with rigid hyperkyphosis, curve magnitude bigger than 70˚ who underwent with multipl Smith Petersen osteotomy and segmental pedicle screw. The aim of the study to show efficacy and safety of this surgical procedure for adult’s hyperkyphosis.

Material and Method:

Between 2011 and 2012, fifteen patients were operated for thoracic hyperkyphosis. Radiologic parameters were evaluated on standing long cassette anteroposterior (AP) and lateral columna vertebralis. We measured the thoracic and lumbar sagittal curve, pelvic incidence angle (PI), pelvic tilt (PT), sacral slope (SS), thoracic inlet alignment (TIA), T1 slope, relationship of the central sacral line (CSVL) preoperatively and at final follow-up.

Result:

The mean 7 (6-8) level SPO was performed in patients and 5,9˚ correction was obtained with each level osteotomy. Intraoperative mean bleeding was 980 ± 429 SD ml mean operative time was 342 ± 429 SD minutes. Patients were followed up for an average of 18,5 ± 5 SD months. The mean preoperative thoracic kyphosis was 79º ± 8,2 SD (70º-90º) and improved to 38º ± 8,3 SD (28º-42º) postoperatively and correction rate was 52% (range 39% to 62 %). Lumbar lordosis was 65º ± 3,3 SD (61º-69º) preoperatively and improved to 40º ± 2,4 SD (37º-43º) postoperatively. There were not significant differences between preoperative and postoperative spinopelvic values. T1 vertebra tilt was improved from 38º ± 2,9 SD to 29º ± 3,8 SD and TIA was improved from 80º ± 5,2 SD to 66º ± 3,1 SD. One dural tear was occurred and treated with suture and fibrin clothe.

Conclusion:

In this small series, using segmental pedicle screw and multipl SPO more than six level, overall correction of the thoracic kyphosis was 52 % and correction was 5,9˚ per one level osteotomy. SPO is effective and safe treatment method for adults with rigid deformity thoracic hyperkyphosis.