Surgical treatment of extremely severe scoliokyphosis by posterior approach:distraction at the ifrst stage by small incisions combined with total spinal osteotomy at the second stage
TAN Rong
MA Hua-song
WU Ji-gong
CHEN Xiao-ming
CHEN Zhi-ming
WANG Dong
LIU Tao
CUI Kai
Abstract：Objective To explore the effectiveness and safety of surgical treatment of extremely severe scoliokyphosis by two stages of posterior distraction and total spinal osteotomy technique.Methods Twenty-six patients with extremely severe scoliokyphosis ( 9 males, 17 females ) were retrospective analyzed. The mean age was 16.8 years ( range: 13-26 years ). The mean preoperative Cobb’s angles were 135.33° ( range: 98°-175° ) for scoliosis and 133.33° ( 96°-170° ) for kyphosis. The surgical procedures were performed by two stages. The ifrst stage surgery was performed with posterior small incisions and distraction technique. Partial corrections of the scoliosis and kyphosis were achieve. The second stage surgery was performed 3-6 months after the ifrst stage surgery by posterior correction with total spinal osteotomy, shave abnormality excision and fusion. The mean follow-up period was 22 months ( range:12-34 months ). Radiographs and clinical data were recorded preoperatively, after the ifrst surgery, before the second surgery, after the second surgery and in the latest follow-up. Perioperative complications were noted.Results All surgeries went smoothly. The average curve magnitude was reduced 61.43° ( 43.4% ) after the ifrst stage surgery and reduced 25.49 ( 34.45% ) after the second stage surgery. The lost of correction between two surgeries was 3.13%. The total major coronal curve correction was 61.8%. Loss of correction averaged 2.92% for major coronal curve and the ifnal correction rate was averaged 58.83%. The average major sagittal curve magnitude was 133.33° ( range: 95°-175° ). The average total major sagittal curve was 79.69° after the ifrst stage surgery, 45° after the second stage surgery, and 47.26° in the latest follow up. Trunk and shoulder imbalance was signiifcantly improved. No severe complications in the spinal cord and respiratory system were noted.Conclusions Two-stage surgery is a safe and effective strategy for extremely severe kyphoscoliosis, which can improve the tolerance of patients to the second operation, reduce the risks and dififculties of the surgery and raise the correction rate and surgery safety.
Keywords：ScoliosisKyphosisSurgical proceduresOperativeOsteotomySpinal curvatures
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 499-503 )