Treatment for Thoracolumbar Kyphosis by Whole Posterior Spinal Osteotomy Combined with Pedicle Screw

Objective To explore the surgery assessment and clinical outcome of the treatment for thoracolumbar kyphosis by whole posterior spinal osteotomy combined with pedicle screw.Methods Fifteen patients including 11 males and 4 females with kyphosis were treated by posterior spinal osteotomy combined with pedicle screw from April 2004 to June 2010.The age of them ranged from 16 to 61 years old averaging at 49.There were 10 cases of old thoracolumbar fracture kyphosis,3 cases of tuberculosis kyphosis,and 2 cases of poor vertebral growth.As for kyphosis vertices,there were 1 case of T9,3 cases of T11,4 cases of T12,5 cases of L1,and 2 cases of L2.Kyphosis Cobb angle ranged from 35° to 61°,averaging at 46°.Based on Franke Grade,there were 2 grade E cases,8 grade D cases,4 grade C cases,and 1 grade B case.Results Intraoperative blood loss was from 800 to 1 800 mL with an average of 1 000 mL;There was 1 case of left thoracic nerve root injury during operation and 1 case of lower extremity muscle strength hypoesthesia after operation.All the 15 patients were followed up for 10 to 30 months with an average time of 12 months.Six months after surgery,Cobb angle ranged from 5° to 10°,with an average correction rate of 86.5%.Six to ten months after osteotomy,X ray showed a good bone healing condition.As for the recovery status of neurological function after surgery,All patients recovered to grade E except 1 patient who returned to grade D from grade B.No such complications as fixation without loosening,fracture or loss of correction degree occurred.Conclusion In posterior spinal osteotomy combined with pedicle screw fixation,decompression and correction can be carried out at the same time to correct a large degree of kyphosis with few complications.The clinical effect is obvious.