Ki Young Lee, Jung-Hee Lee, Kyung-Chung Kang, Won-Young Lee, Jin-Hyung Kim
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However, no study has analyzed the clinical data and usefulness of CO.</p><p><strong>Methods: </strong>This study included 115 patients (mean age: 71.1 yr, mean follow-up period: 78.9 mo) with ASD who underwent deformity correction using PSO or CO. Comparative analysis was performed on spinopelvic parameters including segmental angle (SA) around the osteotomy site, and clinical and surgical assessment between the PSO and corner groups.</p><p><strong>Results: </strong>In the corner group, the postoperative SA (35° vs. -39.3°, P =0.004) and the degree of SA correction (34.8° vs. 39.7°, P =0.004) were greater, and a broader range of SA correction was also possible (18-51° vs. 18-61°). Although the operative time was longer in the corner group (316.8 vs. 342.3 min, P =0.014), the estimated blood loss (EBL) was lower (2841.3 vs. 2465.4 mL, P =0.032). There was no difference in major complication rates, but the frequency of rod fracture (RF) was lower in the corner group (36/27 vs. 1/51, P <0.05).</p><p><strong>Conclusions: </strong>CO showed a greater SA correction and achieved a broader range of SA correction angles than PSO, with no difference in the incidence of major complications. In addition, the EBL and the frequency of RF were lower. 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引用次数: 0
摘要
研究设计回顾性研究：通过与椎弓根减低截骨术（PSO）进行比较，研究角截骨术（CO）在成人脊柱畸形（ASD）患者脊柱前凸矫正中的作用：PSO对ASD患者来说仍然是一种有价值的手术，但对于骨盆内陷较大或曾接受过脊柱融合手术的患者来说，PSO在获得超过45°的矫正角度方面存在局限性。从理论上讲，CO 可以超越 PSO 的限制，获得更大范围的矫正角度。然而，目前还没有研究对 CO 的临床数据和实用性进行分析：本研究纳入了115名使用PSO或CO进行畸形矫正的ASD患者（平均年龄71.1岁，平均随访时间78.9个月）。对比分析了 PSO 组和转角组的脊柱骨盆参数，包括截骨部位周围的节段角度（SA）以及临床和手术评估：转角组的术后SA（35° vs. -39.3°，P=0.004）和SA矫正程度（34.8° vs. 39.7°，P=0.004）更大，SA矫正范围也更广（18-51° vs. 18-61°）。虽然转角组的手术时间更长（316.8 分钟对 342.3 分钟，P=0.014），但估计失血量（EBL）更低（2841.3 毫升对 2465.4 毫升，P=0.032）。主要并发症发生率没有差异，但角部组的杆骨折（RF）发生率较低（36/27 对 1/51，P=0.014）：与 PSO 相比，CO 显示出更大的 SA 矫正效果，达到的 SA 矫正角度范围更广，而主要并发症的发生率没有差异。此外，EBL 和射频频率也较低。基于这些结果，我们预计CO可作为PSO的一种有前途的手术替代方案，用于ASD患者的脊柱畸形矫正。
Corner Osteotomy As the More Advanced Approach to Deformity Correction in Adult Spinal Deformity: A Retrospective Comparative Study Between Two Osteotomy Techniques.
Study design: A retrospective study.
Objective: To investigate the usefulness of corner osteotomy (CO) in patients with adult spinal deformity (ASD) by comparing it with pedicle subtraction osteotomy (PSO) for lordosis correction.
Summary of background data: PSO remains a valuable procedure for patients with ASD, but it has a limit to obtaining correction angles exceeding 45° in patients with a large pelvic incidence or with previous spinal fusion surgeries. Theoretically, CO can exceed the limitation of PSO and can achieve a wide range of correction angles. However, no study has analyzed the clinical data and usefulness of CO.
Methods: This study included 115 patients (mean age: 71.1 yr, mean follow-up period: 78.9 mo) with ASD who underwent deformity correction using PSO or CO. Comparative analysis was performed on spinopelvic parameters including segmental angle (SA) around the osteotomy site, and clinical and surgical assessment between the PSO and corner groups.
Results: In the corner group, the postoperative SA (35° vs. -39.3°, P =0.004) and the degree of SA correction (34.8° vs. 39.7°, P =0.004) were greater, and a broader range of SA correction was also possible (18-51° vs. 18-61°). Although the operative time was longer in the corner group (316.8 vs. 342.3 min, P =0.014), the estimated blood loss (EBL) was lower (2841.3 vs. 2465.4 mL, P =0.032). There was no difference in major complication rates, but the frequency of rod fracture (RF) was lower in the corner group (36/27 vs. 1/51, P <0.05).
Conclusions: CO showed a greater SA correction and achieved a broader range of SA correction angles than PSO, with no difference in the incidence of major complications. In addition, the EBL and the frequency of RF were lower. Based on these results, we expect that CO can serve as a promising surgical alternative to PSO for spinal deformity correction among patients with ASD.
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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