Possible factors associated with sagittal malalignment recurrence after pedicle subtraction osteotomy

European spine journal

article

David Eichler¹  Yann Philippe Charles¹  Florent Baldairon¹  Yves Ntilikina¹  Erik André Sauleau²  Jean-Paul Steib¹ 

[1] Hôpitaux Universitaires de Strasbourg, Université de Strasbourg;Département de Santé Publique, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg

关键词: Sagittal balance;    Thoracolumbar alignment;    Pedicle subtraction osteotomy;    Malalignment recurrence;    Lumbar pseudarthrosis;    Loss of reduction;    Sacroiliac joint laxity;   

DOI  :  10.1007/s00586-018-5767-x

来源: Springer

【 摘 要 】

This retrospective study investigates sagittal alignment after pedicle subtraction osteotomy (PSO). The purpose was to investigate factors associated with malalignment recurrence. Full spine radiographs were analyzed in 66 patients (average age 54.5 years, follow-up 3.8 years). Measurements were taken preoperatively, 3 months postoperatively, at follow-up: SVA C2 and C7, C2–C7 lordosis, T4–T12 kyphosis, L1–S1 lordosis, PSO lordosis, pelvic incidence, pelvic tilt, sacral slope. Follow-up CTs were screened for pseudarthrosis and gas in sacroiliac joints. PSO lordosis increased from 11.8° to 40.8° (p  10°. Gas was evidenced in sacroiliac joints in 22 patients (33%). Postoperative anterior malalignment recurrence may occur after PSO. Elderly patients were at risk of recurrence. Loss of lumbar lordosis linked to pseudarthrosis represented another factor. With malalignment recurrence, anterior trunk rotation and pelvic retroversion might additionally have augmented moments across sacroiliac joints with subsequent ligament laxity and pelvic incidence increase. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown