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Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment
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Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment
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Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment
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Journal Article
Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment
2025
Overview
Purpose
To investigate the influence of apical vertebrae difference (AVD) on surgical decision-making and clinical outcomes of single- and two-level osteotomy in ankylosing spondylitis (AS) thoracolumbar kyphoscoliosis with sagittal and coronal imbalance.
Methods
A total of 27 AS patients with thoracolumbar kyphoscoliosis were enrolled in the study. Patients were divided into single- and two-level osteotomy groups based on the number of osteotomy levels. Coronal, sagittal, and clinical parameters were measured preoperatively, postoperatively, and at the last follow-up. AVD, operation time, blood loss, fused segments and complications were recorded between the two groups.
Results
Among 27 patients, 11 underwent single-level osteotomy and 16 underwent two-level osteotomy. The operation time, blood loss and number of fused segments were lower in single-level group compared to the two-level group (
P
< 0.001). Coronal, sagittal, and clinical parameters improved significantly after surgery (
P
< 0.05), with only osteotomized vertebral angle (OVA) showing a significant difference between the two groups (
P
< 0.05). The average AVD was 1.50 segments in single-level group and 3.30 segments in two-level group. Additionally, single- and two-level osteotomy accounted for 80% and 20% in group A, 77.8% and 22.2% in group B, and 0% and 100% in group C, respectively.
Conclusion
AVD was a crucial parameter in determining whether single- or two-level osteotomy was appropriate for AS patients with thoracolumbar kyphoscoliosis. If the AVD was < 3 segments, single-level osteotomy should be considered. If the AVD was ≥ 3 segments, two-level osteotomy was recommended.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Bone Malalignment - complications
/ Bone Malalignment - diagnostic imaging
/ Female
/ Humans
/ Kyphosis
/ Kyphosis - diagnostic imaging
/ Lumbar Vertebrae - diagnostic imaging
/ Male
/ Medicine
/ Patients
/ Scoliosis - diagnostic imaging
/ Spondylitis, Ankylosing - complications
/ Spondylitis, Ankylosing - diagnostic imaging
/ Spondylitis, Ankylosing - surgery
/ Surgeons
/ Surgery
/ Thoracic Vertebrae - diagnostic imaging
