Oligosegmental Correction of Post-Traumatic Thoracolumbar Angular Kyphosis

Abstract

Seventeen patients with rigid thoracolumbar angular kyphosis due to neglected fractures or dislocations were treated by a standardized single-stage monosegmental or bisegmental anterior discectomy and posterior closing extension wedge osteetomy. The two- or three-level reduction-fixation (RF) instrumentation was used posteriorly for correction and fixation. Choosing angled pedicle screws according to preoperative measurements, the method can always correct the kyphosis to the approximate sagittal curvature that is planned to create preoperatively. The average precorrection of thoracolumbar kyphosis was 39^o and was restored to 1.2^o for an average correction of 37.8^o (range, 22^o-56^o) with subsequent average loss of 1.1^o at final follow-up. Before operation, the complaints were slow progression of kyphotic deformities, fatigue, and pain. All these problems were solved by this procedure. Complications were minimal and mild. No neurologic complications occurred. Follow-up averaged 2.8 years. This method can correct rigid post-traumatic thoracolumbar angular kyphoses to normal geometric relationships as planned preoperatively without much negative effect in lumbar motion and any sacrifice of safety.