Posterior Grade 4 Osteotomy With Vertebral Shortening Is Effective for the Treatment of Kyphosis Associated With Vertebral Discitis/Osteomyelitis

International Journal of Spine Surgery
BarÓn ZÁrate-KalfÓpulosArmando AlpÍzar-Aguirre

Abstract

In the retrospective study of a prospectively maintained database, we present a case series of patients with kyphotic deformity secondary to spinal infection treated using a posterior-only approach with 3-column shortening and posterior instrumentation. This is a case series of patients presenting with postural deformity and sagittal imbalance treated consecutively by 1 surgeon between 2012 and 2014. Clinical assessments and radiographic evaluations were made preoperatively and at 12- and 24-month postoperative follow-ups. All patients underwent computed tomography 24 months after surgery to evaluate spinal fusion. The study included 5 patients with a mean age of 50 years (range, 32-60 years). Three patients had comorbidities. Three patients were classified as American Spinal Injury Association (ASIA) grade C and were not ambulatory; 2 were ASIA grade D. At follow-up, all patients were ambulatory and classified as ASIA grade E. Kyphosis was corrected from a preoperative mean of 32° (range, 15°-58°) to 10° (range, 1°-42°) at the 2-year follow-up. A mean improvement of 22° and 75% reduction in kyphosis was obtained with fixation 2 levels above and below the lesion. Interbody fusion was observed in all patients. No major complicat...Continue Reading

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