Novel, safe, and easy spinal osteotomy for regional kyphotic deformities

Abstract

Objective: This study aimed to assess the efficacy and safety of a newly developed transpedicular, anterior open-wedge osteotomy procedure with lamina preservation to correct sagittal imbalance in regional kyphotic deformities following compression fractures. Methods: All seven patients [four females and three males; mean (range) age, 67 (56-78) years] included in this study underwent surgery between May 2005 and May 2016 for symptomatic, rigid kyphosis secondary to compression fractures. Transpedicular, anterior open-wedge osteotomy with lamina preservation was performed in all patients using an osteotome to create a transverse fracture in the vertebral body through bilateral pedicles and an anterior open-wedge space filled with compacted bone graft to correct kyphosis. Pre-and post-operative kyphotic Cobb angles were evaluated, and the volume of intra-operative blood loss was measured. Results: The pre-and post-operative kyphotic Cobb angle was 35.3° and 17.7°, respectively (p<0.01); mean angle correction was 17.6° (p<0.05). No patient developed any complication with neurologic injury. Mean blood loss was 771 mL. Callus formation viewed on plain film was evident in all patients and was accompanied by decreased thoracolumbar back pain. Conclusion: Transpedicular, anterior open-wedge osteotomy with lamina preservation is an easy and safe spinal osteotomy procedure for the correction of regional, fixed kyphotic deformities. Level of Evidence: Level IV, Therapeutic study.