Correction of Thoraco-Lumbar Kyphotic Deformity using a Posterior Interbody Fusion

Park, Byung Chul; Lee, Seong Man

Abstract

PURPOSE: This is a retrospective study evaluating the efficacy of posterior thoraco-lumbar interbody fusion for the treatment of thoraco-lumbar kyphotic deformity.
MATERIALS AND METHODS
A posterior thoraco-lumbar interbody fusion was performed in 10 patients with thoracolumbar kyphotic deformity from April 1996 to April 1999. The mean age was 39.5 years (range 16 ~59 years), and five were male and five were female. The cause of deformity was tuberculous spondylitis in 7 cases, post-traumatic kyphosis in 2 cases, and ankylosing spondylitis in 1 case. Three cases involved thoracic spine alone, 3 cases involved thoracolumbar junction, and 4 cases involved lumbar spine alone. The chief complaint was lower back pain in 6 cases, progression of deformity in 2 cases, and both type in 2 cases. There was no patients with neurologic symptoms or signs. The average postoperative follow-up period was 19.5 months (range 12~33 months)
RESULTS
By standard Cobb measurement, the mean preoperative kyphosis of 43.7 degrees was reduced to 19.3 degrees in the immediate postoperation and to 22.5 degrees in the last follow-up. Mean correction rate was 51.4% and average loss of correction was 3.2 degrees. Interbody fusion was achieved in 9 cases out of 10 by criteria of Lee et al. Clinical results such as back pain, fatigue pain, and tingling sensation were improved in 8 cases out of 10 by criteria of Lin et al. Nine patients were satisfied with the correction of the deformity. Mean operation time was 255 minutes and average amount of transfusion was 1400 ml(3.5 pints) of packed red cell. There was no serious complications like paraplegia or death.
CONCLUSION
A posterior thoraco-lumbar interbody fusion is a relatively easy, safe and good-outcome technique for treatment of moderate thoraco-lumbar kyphotic deformity