Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report

Shuchi Lv; Jianyu Zou; Guowei Zhang; Hua Yang; Zhisheng Ji; Hongsheng Lin

doi:doi:10.11648/j.ijn.20230702.14

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Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report

Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, Hongsheng Lin

Published in International Journal of Neurosurgery (Volume 7, Issue 2)

Received: 11 September 2023 Accepted: 9 October 2023 Published: 31 October 2023

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Abstract

Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.

Published in	International Journal of Neurosurgery (Volume 7, Issue 2)
DOI	10.11648/j.ijn.20230702.14
Page(s)	36-40
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Kyphosis, Pedicle Subtraction Osteotomy, Deformed Compound Vertebra, Sagittal Balance, Case Report

References

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[2]	BUCHOWSKI J M, KUHNS C A, BRIDWELL K H, et al. Surgical management of posttraumatic thoracolumbar kyphosis [J]. Spine J, 2008, 8(4): 666-77.
[3]	VACCARO A R, SILBER J S. Post-traumatic spinal deformity [J]. Spine (Phila Pa 1976), 2001, 26(24 Suppl): S111-8.
[4]	SONG K S, CHANG B S, YEOM J S, et al. Surgical treatment of severe angular kyphosis with myelopathy: anterior and posterior approach with pedicle screw instrumentation [J]. Spine (Phila Pa 1976), 2008, 33(11): 1229-35.
[5]	ZHANG H Q, XIAO L G, GUO C F, et al. Deformed Complex Vertebral Osteotomy Technique for Management of Severe Congenital Spinal Angular Kyphotic Deformity [J]. Orthop Surg, 2021, 13(3): 1016-25.
[6]	SAR C, ERALP L. Three-stage surgery in the management of severe rigid angular kyphosis [J]. Eur Spine J, 2002, 11(2): 107-14.
[7]	ZHANG H Q, DENG A, GUO C F, et al. Retrospective analysis of deformed complex vertebral osteotomy in children with severe thoracic post-tubercular angular kyphosis [J]. BMC Musculoskelet Disord, 2022, 23(1): 805.
[8]	WANG S, AIKENMU K, ZHANG J, et al. The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis [J]. Eur Spine J, 2017, 26(7): 1817-25.
[9]	BURTON D C. Smith-Petersen osteotomy of the spine [J]. Instr Course Lect, 2006, 55: 577-82.
[10]	CHO K J, BRIDWELL K H, LENKE L G, et al. Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance [J]. Spine (Phila Pa 1976), 2005, 30(18): 2030-7; discussion 8.
[11]	HU X, THAPA A J, CAI Z, et al. Comparison of smith-petersen osteotomy, pedicular subtraction osteotomy, and poly-segmental wedge osteotomy in treating rigid thoracolumbar kyphotic deformity in ankylosing spondylitis a systematic review and meta-analysis [J]. BMC Surg, 2016, 16: 4.
[12]	PARK J S, KIM J, JOO I H, et al. Analysis of risk factors for sagittal translation after pedicle subtraction osteotomy in patients with ankylosing spondylitis [J]. Spine J, 2018, 18(8): 1356-62.
[13]	RILEY M S, LENKE L G, CHAPMAN T M, JR., et al. Clinical and Radiographic Outcomes After Posterior Vertebral Column Resection for Severe Spinal Deformity with Five-Year Follow-up [J]. J Bone Joint Surg Am, 2018, 100(5): 396-405.
[14]	SCHWAB F, BLONDEL B, CHAY E, et al. The comprehensive anatomical spinal osteotomy classification [J]. Neurosurgery, 2014, 74(1): 112-20; discussion 20.
[15]	YANG C, ZHENG Z, LIU H, et al. Posterior vertebral column resection in spinal deformity: a systematic review [J]. Eur Spine J, 2016, 25(8): 2368-75.

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APA Style

Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, et al. (2023). Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. International Journal of Neurosurgery, 7(2), 36-40. https://doi.org/10.11648/j.ijn.20230702.14

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ACS Style

Shuchi Lv; Jianyu Zou; Guowei Zhang; Hua Yang; Zhisheng Ji, et al. Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. Int. J. Neurosurg. 2023, 7(2), 36-40. doi: 10.11648/j.ijn.20230702.14

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AMA Style

Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, et al. Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. Int J Neurosurg. 2023;7(2):36-40. doi: 10.11648/j.ijn.20230702.14

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@article{10.11648/j.ijn.20230702.14,
  author = {Shuchi Lv and Jianyu Zou and Guowei Zhang and Hua Yang and Zhisheng Ji and Hongsheng Lin},
  title = {Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report},
  journal = {International Journal of Neurosurgery},
  volume = {7},
  number = {2},
  pages = {36-40},
  doi = {10.11648/j.ijn.20230702.14},
  url = {https://doi.org/10.11648/j.ijn.20230702.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20230702.14},
  abstract = {Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.
},
 year = {2023}
}

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TY  - JOUR
T1  - Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report
AU  - Shuchi Lv
AU  - Jianyu Zou
AU  - Guowei Zhang
AU  - Hua Yang
AU  - Zhisheng Ji
AU  - Hongsheng Lin
Y1  - 2023/10/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ijn.20230702.14
DO  - 10.11648/j.ijn.20230702.14
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 36
EP  - 40
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20230702.14
AB  - Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.

VL  - 7
IS  - 2
ER  -

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Author Information

Shuchi Lv

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Jianyu Zou

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Guowei Zhang

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Hua Yang

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Zhisheng Ji

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Hongsheng Lin

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

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APA Style

Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, et al. (2023). Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. International Journal of Neurosurgery, 7(2), 36-40. https://doi.org/10.11648/j.ijn.20230702.14

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ACS Style

Shuchi Lv; Jianyu Zou; Guowei Zhang; Hua Yang; Zhisheng Ji, et al. Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. Int. J. Neurosurg. 2023, 7(2), 36-40. doi: 10.11648/j.ijn.20230702.14

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AMA Style

Shuchi Lv, Jianyu Zou, Guowei Zhang, Hua Yang, Zhisheng Ji, et al. Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report. Int J Neurosurg. 2023;7(2):36-40. doi: 10.11648/j.ijn.20230702.14

Copy | Download

@article{10.11648/j.ijn.20230702.14,
  author = {Shuchi Lv and Jianyu Zou and Guowei Zhang and Hua Yang and Zhisheng Ji and Hongsheng Lin},
  title = {Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report},
  journal = {International Journal of Neurosurgery},
  volume = {7},
  number = {2},
  pages = {36-40},
  doi = {10.11648/j.ijn.20230702.14},
  url = {https://doi.org/10.11648/j.ijn.20230702.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20230702.14},
  abstract = {Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.
},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Treatment of Post-Traumatic Kyphosis of the Spine with Pedicle Subtraction Osteotomy: Case Report
AU  - Shuchi Lv
AU  - Jianyu Zou
AU  - Guowei Zhang
AU  - Hua Yang
AU  - Zhisheng Ji
AU  - Hongsheng Lin
Y1  - 2023/10/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ijn.20230702.14
DO  - 10.11648/j.ijn.20230702.14
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 36
EP  - 40
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20230702.14
AB  - Kyphosis refers to a deformity in which the spine protrudes abnormally backwards, which involves changes in the anatomical shape of the vertebral body itself and its subsidiary tissues. Kyphosis can cause abnormal appearance, inability to look up and lie down, psychological disturbance, and severe cases can cause dyspnea. We have reported a 40-year-old female patient who was admitted to the hospital due to a 37-year history of kyphosis following a fall. The measurement of preoperative imaging parameters indicated: pelvic incidence (PI) = 40°, pelvic tilt (PT) = 9°, sacral slope (SS) = 31°, lumbar lordosis (LL) = 80°, thoracic kyphosis (TK) = 57°, local kyphosis angle = 137.7°. Based on thorough preoperative planning and discussion, we performed deformed Complex vertebral osteotomy (DCVO). After the surgery, the patient's height was 151cm, which increased by 5cm compared to preoperative height. The postoperative measurements were as follows: pelvic incidence (PI) = 35°, pelvic tilt (PT) = 4.8°, sacral slope (SS) = 40°, lumbar lordosis (LL) = 73°, thoracic kyphosis (TK) = 63°, and local kyphosis angle = 59°. After the operation, the patient recovered well, the treatment effect was satisfactory, and the quality of life was significantly improved. The DCVO technique is a high-risk, demanding procedure that needs to be performed by an experienced spinal surgery team.

VL  - 7
IS  - 2
ER  -

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