A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study
Abstract Severe sharp angular kyphosis resulting from Pott’s disease typically necessitates surgical intervention. The deployment of three-column osteotomy within the lesion and apical regions has been validated as an effective modality for the amelioration of angular kyphosis. Nonetheless, a propen...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-48891-y |
| _version_ | 1797398026301472768 |
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| author | Deng Zhao Fei Wang Zhengjun Hu Rui Zhong Huaqiang Huang Zhong Zhang Dengxu Jiang Yan Liang Yijian Liang |
| author_facet | Deng Zhao Fei Wang Zhengjun Hu Rui Zhong Huaqiang Huang Zhong Zhang Dengxu Jiang Yan Liang Yijian Liang |
| author_sort | Deng Zhao |
| collection | DOAJ |
| description | Abstract Severe sharp angular kyphosis resulting from Pott’s disease typically necessitates surgical intervention. The deployment of three-column osteotomy within the lesion and apical regions has been validated as an effective modality for the amelioration of angular kyphosis. Nonetheless, a propensity for residual kyphosis persists, accompanied by a significant perioperative risk profile. In pursuit of optimizing correctional outcomes and diminishing complication rates, we proposed an innovative surgical approach, utilizing osteotomy in the non-lesioned zones for the rectification of severe angular kyphosis associated with Pott’s disease. This retrospective investigation encompasses 16 subjects who underwent this novel surgical tactic, involving osteotomies in non-lesioned vertebral segments, at our institution from 2016 to 2018. Radiographic measures, encompassing kyphotic angle and sagittal vertical axis (SVA), were documented at baseline and during terminal follow-up. Neurological status was evaluated via the American Spinal Injury Association (ASIA) grading system. Operative duration, volume of hemorrhage, and perioperative complications were systematically recorded. The cohort included 6 males and 10 females with an average age of 30.7 ± 11.41 years. Follow-up intervals spanned 24 to 42 months. Mean operative time and blood loss were 492 ± 127.3 min and 1791 ± 788.8 ml, respectively. The kyphotic angle improved from 97.6 ± 14.6° to 28.8 ± 18.70°. In cases with lumbar afflictions, vertebral restoration was achieved (L1–L5 and L2–S1). Initial mean SVA of 6.7 ± 3.58 cm was reduced to 3.3 ± 1.57 cm at follow-up. Neurological function enhancement was observed in six patients, while ten maintained baseline status. Complication rates, including wound infection and rod fracture at 12 months, were observed in approximately 11.8% of cases. Our findings suggest that the surgical strategy is both effective and safe for addressing severe angular kyphosis due to Pott’s disease, contingent upon the expertise of the surgical unit. |
| first_indexed | 2024-03-09T01:18:47Z |
| format | Article |
| id | doaj.art-9e4b43fa32e64b68878233445128e443 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T01:18:47Z |
| publishDate | 2023-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-9e4b43fa32e64b68878233445128e4432023-12-10T12:17:05ZengNature PortfolioScientific Reports2045-23222023-12-011311810.1038/s41598-023-48891-yA novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively studyDeng Zhao0Fei Wang1Zhengjun Hu2Rui Zhong3Huaqiang Huang4Zhong Zhang5Dengxu Jiang6Yan Liang7Yijian Liang8Department of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Spinal Surgery, Peking University People’s HospitalDepartment of Orthopaedics, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityAbstract Severe sharp angular kyphosis resulting from Pott’s disease typically necessitates surgical intervention. The deployment of three-column osteotomy within the lesion and apical regions has been validated as an effective modality for the amelioration of angular kyphosis. Nonetheless, a propensity for residual kyphosis persists, accompanied by a significant perioperative risk profile. In pursuit of optimizing correctional outcomes and diminishing complication rates, we proposed an innovative surgical approach, utilizing osteotomy in the non-lesioned zones for the rectification of severe angular kyphosis associated with Pott’s disease. This retrospective investigation encompasses 16 subjects who underwent this novel surgical tactic, involving osteotomies in non-lesioned vertebral segments, at our institution from 2016 to 2018. Radiographic measures, encompassing kyphotic angle and sagittal vertical axis (SVA), were documented at baseline and during terminal follow-up. Neurological status was evaluated via the American Spinal Injury Association (ASIA) grading system. Operative duration, volume of hemorrhage, and perioperative complications were systematically recorded. The cohort included 6 males and 10 females with an average age of 30.7 ± 11.41 years. Follow-up intervals spanned 24 to 42 months. Mean operative time and blood loss were 492 ± 127.3 min and 1791 ± 788.8 ml, respectively. The kyphotic angle improved from 97.6 ± 14.6° to 28.8 ± 18.70°. In cases with lumbar afflictions, vertebral restoration was achieved (L1–L5 and L2–S1). Initial mean SVA of 6.7 ± 3.58 cm was reduced to 3.3 ± 1.57 cm at follow-up. Neurological function enhancement was observed in six patients, while ten maintained baseline status. Complication rates, including wound infection and rod fracture at 12 months, were observed in approximately 11.8% of cases. Our findings suggest that the surgical strategy is both effective and safe for addressing severe angular kyphosis due to Pott’s disease, contingent upon the expertise of the surgical unit.https://doi.org/10.1038/s41598-023-48891-y |
| spellingShingle | Deng Zhao Fei Wang Zhengjun Hu Rui Zhong Huaqiang Huang Zhong Zhang Dengxu Jiang Yan Liang Yijian Liang A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study Scientific Reports |
| title | A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study |
| title_full | A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study |
| title_fullStr | A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study |
| title_full_unstemmed | A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study |
| title_short | A novel surgical strategy of three column osteotomy at non-lesioned area for correcting severe angular kyphosis due to Pott’s disease: a retrospectively study |
| title_sort | novel surgical strategy of three column osteotomy at non lesioned area for correcting severe angular kyphosis due to pott s disease a retrospectively study |
| url | https://doi.org/10.1038/s41598-023-48891-y |
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