Sagittal translation in opening wedge osteotomy for the correction of thoracolumbar kyphotic deformity in ankylosing spondylitis

Spine
Kao-Wha ChangYou-Hong Cai

Abstract

Retrospective. To document sagittal translation (ST) of the vertebral column in opening wedge osteotomy (OWO) for ankylosing spondylitis (AS) kyphosis. Surgeons recognize displacement at the hinge of correction in OWO as an accidental event between the vertebrae on the side of OWO rather than ST of the cranial or caudal vertebral column. No report documents ST in this context. We evaluated radiographic and clinical results in 127 patients (aged 17-49 years) for ST, or displacement of more than 2 mm between the cranial and caudal vertebral columns at the OWO level, over 5 years. Thirty-four (27%) patients had ST. In 31 (94%), the kyphotic apex was at T11 to L4. ST was positively correlated with the correction of lumbar lordosis and preoperative lumbar kyphosis. Five (15%) of 34 patients with ST had neurologic complications compared with 2 (2%) of 93 who did not. ST is a basic mechanism for correcting sagittal imbalance and is likely to occur when the level of OWO is near the apex of deformity. Patients needing more correction of lumbar lordosis than others for best correction of sagittal imbalance need ST more to join the mechanism of correction.

References

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Citations

Jun 4, 2008·Spine·Kao-Wha ChangTsung-Chein Chen
Jun 19, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Hong Qi ZhangMing Xing Tang
Aug 21, 2013·The Spine Journal : Official Journal of the North American Spine Society·Constantin SchizasGerit Kulik
Oct 24, 2018·Spine Deformity·Chia-Hung SzeScott J Luhmann
Jan 1, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Heiko KollerWolfgang Hitzl
Nov 1, 2018·Spine Deformity·Chia-Hung SzeScott J Luhmann
Jun 13, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Wei ZhangYichen Wang

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