J Korean Orthop Assoc.  2011 Jun;46(3):200-204. 10.4055/jkoa.2011.46.3.200.

The Comparative Study between Combined and Posterior Surgical Treatments for Post-traumatic Kyphosis

• Park YS
• Lee YS
• Back SW
• Kim JH
• Lee DY

• KMID: 2185445
• DOI: http://doi.org/10.4055/jkoa.2011.46.3.200

Abstract

PURPOSE
We wanted to analyse the differences of the radiological and clinical results between the combined approach and the posterior approach for treating posttraumatic kyphosis in elderly patients and to determine the risk factors for the loss of correction after the operation.
MATERIALS AND METHODS
Between September 2004 and August 2009, 19 patients who underwent an operation for posttraumatic kyphosis and were follow-up for at least one year were included in this study. The combined approach (A group) was done for 10 patients, while the posterior approach (B group) was done for 9 patients. Radiological study and clinical evaluation, including the Korean version of the Oswestry disability index and the visual analog scale (VAS), were performed before surgery, after surgery and at the final follow-up. The risk factors related to the loss of correction of kyphosis at the fracture site were analyzed.
RESULTS
In group A, the mean kyphotic angles were 35.2 before surgery, 11.1 degrees after surgery and 15.7 degrees at the final follow-up. There was 24.1 degrees (correction; 68.5%) of correction of the kyphotic angle with 4.6 degrees (19%) loss of correction. In group B, the mean kyphotic angles were 34.2 before surgery, 9.3 degrees after surgery and 13.8 degrees at the final follow-up. There was 24.9 degrees (72.8%) correction of the kyphotic angle with 4.5 degrees (18.3%) loss of correction. The clinical data was improved to the same degrees. The loss of correction was statistically correlated with osteoporosis.
CONCLUSION
In conclusion, the posterior approach can correct the posttraumatic kyphosis in a fashion similar to that of the combined approach. The patient's osteoporosis should be thoroughly treated for preventing correction loss.

Keyword

posttraumatic kyphosis; posterior approach; combined approach

MeSH Terms

Aged
Follow-Up Studies
Humans
Kyphosis
Osteoporosis
Risk Factors

Figure

• 

  Figure 1 The operative techniques in both groups are shown as followings. (A) A 56-years old woman who had already old compression fractures at T12 and L1, received an anterior corpectomy and anterior fusion. Two weeks after the initial operation, the posterior fusion was done. (B) A 66-year-old woman who had suffered from the old compression fracture at T12 with kyphotic deformity, was operated upon through the posterior approach. A pedicle subtraction osteotomy was done at L1 body, followed by posterior and posterolateral fusion from T10 to L5.

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