Three-column osteotomy surgery versus standard surgical management for the correction of adult spinal deformity: a cohort study

Journal of Orthopaedic Surgery and Research

Peifu Tang³  Sigurd Berven¹  Wei Zhang³  Lihai Zhang³  Yiling Zhang³  Hua Chen³  Xinran Ji² 

[1] Department of Orthopaedic Surgery, Spine Fellowship and Resident Education Program, University of California, San Francisco, 500 Parnassus Ave., MU320W, San Francisco 94143-0728, CA, USA;Department of Orthopaedic Surgery, Medical Center, University of California, San Francisco, 500 Parnassus Ave., MU320W, San Francisco 94143-0728, CA, USA;Department of Orthopaedic Surgery, The General Hospital of People’s Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing 100000, China

关键词: Adult spinal deformity;    Three-column osteotomy;    Standard surgical management;   

Others  :  1133008
DOI  :  10.1186/s13018-015-0154-3

 received in 2014-07-18, accepted in 2015-01-03,  发布年份 2015

【 摘 要 】

Background

The aim of this study was to analyze and compare the surgical data, clinical outcomes, and complications between three-column osteotomy (3-COS) and standard surgical management (SSM) for the treatment of adult spine deformity (ASD).

Methods

A total of 112 patients who underwent consecutive 3-COS (n = 48) and SSM (n = 64) procedures for ASD correction at a single institution from 2001 to 2011 were reviewed in this study. The outcomes were assessed using the Scoliosis Research Society (SRS)-22 scores. The complications of patients with 3-COS and SSM were also compared.

Results

No significant differences were found in patient characteristics between SSM and 3-COS groups. Surgical data and radiographic parameters showed that the patients of the 3-COS group suffered more severe ASD than those of the SSM group. The distribution of surgical complications revealed that SSM group underwent more complications than 3-COS groups with no significant differences. At final follow-up, the total SRS-22 score of SSM was not significant between pre-operation and post-operation. However, the total SRS-22 score of 3-COS at final follow-up was significantly higher than pre-operation.

Conclusion

For severe ASD patients with high grade pelvic incidence (PI), pelvic tilt (PT), and PI/lumbar lordosis (LL) mismatch and who have subjected to spine surgeries more than twice before, 3-COS might be more effective than SSM in improving the clinical outcomes. However, due to the higher reoperation rate of 3-COS, SSM may be more appropriate than SSM for correcting the not serious ASD patients.

【 授权许可】

   
2015 Ji et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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