Spine recently published an article examining the radiographical and clinical outcomes of posterior column osteotomies for spinal deformity correction.
The researchers examined 128 patients who underwent posterior spinal fusion with posterior column osteotomies. The patients were followed for two years and 75 were primary surgical procedures; the remaining 53 patients were revisions.
Ian G. Dorward, MD, Lawrence G. Lenke, MD, Geoffrey E. Stoker, BS, Woojin Cho, MD, PhD, Linda A. Koester, BS, and Brenda A. Sides, MS, authored the article.
1. With PCOs at the apex of the curve, the maximum coronal Cobb decreased from 66 degrees ± 21 degrees to 31 degrees ± 14 degrees. The average kyphosis correction was 8.8 degrees ± 7.2 degrees, with the patient's age and region of the spine impacting correction.
2. The average blood loss was 1,419 ± 887 mL and older patients experienced greater blood loss. The blood loss also increased with a larger number of instrumented levels. However, the number of PCOs did not increase blood loss. The average patient age was 37.6 ± 21 years and surgeons performed an average of 14.4 ± 3 instrumented levels.
3. There were 31 patients who experienced complications. Four patients had radiculopathies. None of the complications were attributable to PCOs and the complications did not correlate with the number of PCOs. However, there were six patients who had loss of spinal cord monitoring or failed the wake-up test that could be attributed to overcorrection with PCOs, but none had postoperative deficits.
4. Oswestry Disability Index scores improved from 34.4 ± 17 to 23.6 ± 18. The normalized Scoliosis Research Society-30 scores improved from 63.7 ± 17 to 76.4 ± 15. "Patients in this series undergoing posterior spinal fusion with PCOs achieved overall favorable outcomes for spinal deformity correction," the article authors concluded.
5. A study published in Asian Spine Journal last year examined whether posterior surgery alone could treat post-traumatic kyphosis. Researchers treated 26 patients with posterior column osteotomy, spondylodesis, instrumentation and cement vertebroplasty in one stage posterior surgery. The researchers found solid fusion occurring in 96.2 percent of patients.
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