Bai Yunsong,Zhang Xuejun,Gao Rongxuan,et al.Posterior-only multi-segment Ponte osteotomies with internal fixation and fusion in adolescent Scheuermann’s kyphosis[J].Journal of Clinical Pediatric Surgery,,20():737-742.[doi:10.12260/lcxewkzz.2021.08.007]
Posterior-only multi-segment Ponte osteotomies with internal fixation and fusion in adolescent Scheuermann’s kyphosis
- Keywords:
- Scheuermann Disease; Kyphosis; Ponte osteotomy; Treatment Outcome; Adolescent
- CLC:
- R682.3;R726.8
- Abstract:
- Objective To evaluate the surgical outcomes of posterior-only multi-segment Ponte osteotomies with internal fixation and fusion for adolescent Scheuermann’s kyphosis (SK). Methods Clinical data were retrospectively reviewed for 18 undergoing posterior-only multi-segment Ponte osteotomies with internal fixation and fusion from July 2012 to December 2018. There are 14 boys and 4 girls with an average age of (6.50±3.22)(2.17-13.00) years. Standing anteroposterior and lateral radiographs of full-spine were recorded and compared preoperatively, postoperatively and at the last follow-up. Radiographic parameters included global kyphosis (GK), proximal junctional angle (PJA), distal junctional angle (DJA), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). Results The mean follow-up period was (38.10±15.32)(24-70) months. Ponte osteotomy segments had an average of (7.4±1.1)(6-9). GK was (78.3±10.6)°preoperatively, (32.3±8.4)° (correction rate of 58.7%) postoperatively and (34.1±6.2)° at the latest follow-up. TK and LL post-operation were significantly lower than those pre-operation (P<0.05) and there was no significant difference from the last follow-up (P>0.05). PJA, DJA, SVA and sagittal spinopelvic parameters (PI/PT/SS) were not significantly different from those pre-operation and the last follow-up (P>0.05). There was no occurrence of neurologic complication, proximal junctional kyphosis, distal junctional kyphosis, infection, pseudarthrosis, correction loss or instrumentation-related complication during follow-ups. Conclusion Posterior-only multi-segment Ponte osteotomies with internal fixation and fusion is both safe and effective for adolescent SK. And surgical outcomes were satisfactory during a follow-up period of over 2 years. In our experience, the spinopelvic parameters did not change after surgery.
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Memo
收稿日期:2021-06-07。
基金项目:北京市医院管理局临床技术创新项目（扬帆）
通讯作者:张学军,Email:zhang-x-j04@163.com