ABSTRACT

Progressive kyphotic deformity leads to postural, emotional and functional impairment in patients with ankylosing spondylitis. Although the disease affects the whole spine, lumbar region is the site of choice for corrective osteotomy. In this study, 20 patients treated by lumbar transpedicular closing wedge osteotomy for kyphotic deformity due to ankylosing spondilytis were analyzed regarding sagittal alignment, deformity magnitude, amount of correction and complications, with a minimum follow-up of two years. Total kyphotic deformity averaged 68.7° preoperatively, 28.3° postoperatively and 48.7° at follow-up. The increase in total kyphotic deformity between the early postoperative period and the last follow-up was statistically significant (p<0,01) Assessment of the osteotomy site revealed average correction of 37.6° (28°-58°) and an average 3° (0°-10°) loss of correction. There was no mortality, nor were there any permanent neurological complications. All patients were able to look straight ahead and abdominal plications disappeared postoperatively. One patient underwent a second lumbar osteotomy due to recurrence of deformity at proximal segments in the long term follow-up. Although total kyphotic deformity increased in the follow-up period, the patients did not return to their preoperative status. Lumbar transpedicular closing wedge osteotomy is safe and effective for correction of kyphotic deformity in ankylosing spondylitis.