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首页> 外文期刊>Neurosurgery >Thoracic Kyphotic Deformity Reduction with a Distractible Titanium Cage via an Entirely Posterior Approach
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Thoracic Kyphotic Deformity Reduction with a Distractible Titanium Cage via an Entirely Posterior Approach

机译：通过完全后路入路可分散的钛笼降低胸椎后凸畸形

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OBJECTIVE: Surgical correction of thoracic kypholic deformity is often associated with significant surgical anfl neurological morbidity and unsatisfactory reduction ofkypho-sis, especially in palienls who cannol lolerale anlerior thoracic procedures because of associated comorbidiiy. We describe a technique in which kypholic deformity of the thoracic and thoracolumbar spine is corrected, decompressed, and stabilized with a circumferential fixation construct from a lone posterior approach. METHODS: We reviewed the radiographic and clinical outcomes of seven patients undergoing vertebrectomy via a bilateral modified costotransversectomy approach followed by posterior placement of a distractible cage, reduction of the deformity via cage distraction, and supplemental dorsal instrumentation. All patients possessed ihoracic/tho-racolumbar kvphosis; however, a translhoracic approach was thought to be high risk because of medical comorbidiiy. RESULTS: Seven palienls underwent this procedure for ihoracolumbar kvphosis resulting from a spinal tumor, osteomyelitis, and fracture. Vertebrectomies were performed al T2-T.5, T4-T5j, T4-T6, Tl2-L1, and L1. The mean preoperative kyphosis was 28.6 degrees, the mean postoperative kyphosis al the lime of the final follow-up examination was 12.1 degrees, and the mean change in kyphosis was 5 5%. The mean long-term follow-up period was approximately 16 months. Al the lime of ihe final follow-up examination for all palienls, there was no decline in neurological funclion, and pain management consisted of minimal use of oral narcotics. CONCLUSION: This tec hnique allows for circumferential decompression of the spinal cord via a posterior approach in palienls with thoracic kyphotic deformities who cannol lolerale anterior thoracic approaches. In addition, in situ distraction of the expandable1 cage allows correction of sagitlal imbalance and restores height without the potential loss of spinal height associated with osteotomies.
机译：目的：外科矫正胸椎后凸畸形通常与明显的手术神经病学发病率和后凸畸形的降低不令人满意有关，尤其是在因相关合并症而接受大腿无瓣胸廓手术的​​患者中。我们描述了一种技术，该技术通过单独的后路入路矫正，减压和稳定术来矫正，减压和稳定脊柱和胸腰椎的后凸畸形。方法：我们回顾了七例经双侧改良肋横突切除术进行椎体切除术的放射学和临床结局，随后通过放置可分散的笼子，通过笼子撑开术减少畸形和补充背侧器械。所有患者均患有虹膜/胸腰椎角膜变态。然而，由于医学上的合并症，经胸腔入路的方法被认为是高风险的。结果：七个苍白接受了因脊柱肿瘤，骨髓炎和骨折而导致的异位胸腰段性角膜突出症的手术。椎骨切除术在T2-T.5，T4-T5j，T4-T6，Tl2-L1和L1中进行。术前平均驼背度为28.6度，最终随访检查的平均术后驼背度为12.1度，驼背度的平均变化为5 5％。平均长期随访期约为16个月。在所有患者的最终随访检查中，神经功能没有下降，并且疼痛管理包括尽量少用口服麻醉药。结论：该技术可在患有脊柱后凸畸形的患者中进行后路入路，从而实现脊髓的圆周减压。此外，可扩张笼的原位牵张可以矫正矢状不平衡并恢复身高，而不会因切骨术而造成脊柱高度的潜在损失。

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