Clinical Application and Exploration on Steps Progressively Corrections and Gradual Shortening Combined with Total Spinal Osteotomy for Angular Kyphosis—Basic Research and Clinical Application ()
ABSTRACT
Introduction: This study is designed to explore the biomechanical principles
of posterior bilateral pedicle screw on steps progressively and tight closure on every step for severe angular kyphosis and the indication conditions and clinical
pathways of above new technique. Materials and Methods: A total of 90 patients have
severe angular kyphosis, 37 males and 53 females, with an average age of 47 years.
All patients were treated with posterior bilateral pedicle screw and step tight
closure for gradual shortening and orthopedic technology. Results: Average intraoperative
blood loss was 2089 ml. Average operation time was 326 minutes. Kyphotic angle changed
from 90.1° averagely preoperatively to 41.6° averagely postoperatively with an improvement
rate of 65%. The distance from C7 plumb line to posterior upper edge
of the S1 vertebral body was averagely 5.2 mm postoperatively, with a
correction rate of 73%. Neurological complications
occurred in 2 cases, accounting for 6%. Non-neurological complications occurred
in 2 cases, accounting for 6%. Anatomical parameters were significantly improved
postoperatively (P < 0.05). All patients were averagely followed up for 28 months.
Segments undergoing osteotomy achieved bone fusion, without loss of orthopedic angle.
Conclusions: The orthopedic technology of bilateral pedicle screw and step tight
closure designed by human physiology and biomechanical principles can protect spinal
cord cells from injury to the utmost. To choose an appropriate osteotomy plane during
pre-surgical planning can make the repair results closer to the normal function
of the spine. Intraoperative nerve root protection, full release and bone graft
fusion are effective safeguards to ensure kyphosis correction and to avoid spine
lateral offset.
Share and Cite:
Lu, M. , Wang, X. , Ren, D. and Ma, H. (2016) Clinical Application and Exploration on Steps Progressively Corrections and Gradual Shortening Combined with Total Spinal Osteotomy for Angular Kyphosis—Basic Research and Clinical Application.
Surgical Science,
7, 39-47. doi:
10.4236/ss.2016.71005.
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