Correction of post-traumatic kyphosis in the thoracolumbar spine through an anterior approach using an artificial vertebral body / 中华骨科杂志

ABSTRACT

Objective To investigate the efficacy and safety of anterior approach using an expandable artificial vertebral body for the correction of post-traumatic kyphosis (PTK) in the thoracolumbar spine.Methods From August 2009 to August 2011,13 patients with PTK in the thoracolumbar spine were treated through an anterior approach using an expandable artificial vertebral body.There were 4 males and 9 females,aged from 38 to 62 years (average,53.3±7.6 years).The injury levels consisted of T12 in 5 cases,L1 in 6 cases and L2 in 2 cases.All the operations were done by a single surgeon group.In the procedure,symptomatic vertebra and its two discs were excised,and the bony endplates were reserved.After putting an expandable artificial vertebral body into the space,the kyphosis was corrected by extending the artificial vertebral body.The operative duration,blood loss,Cobb angle,visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded.Results All patients were successfully followed up for an average time of (18±5.5) months (range,12 to 28 months).The average Cobb angle was 33.9°±7.2°(range,22°to 53°)before operation and 7.3°±4.8°(range,2°to 16°)at final follow-up.The average VAS score was 6.4±0.9 (range,5 to 8)before operation and 1.5±0.8(range,0 to 3)at final follow-up.The average ODI was 50.5％±10.8％(range,38％ to 78％)before operation and 10.9％±4.9％(range,4％ to 22％) at final follow-up.All patients achieved bony fusion 12 months after operation.Conclusion Application of expandable artificial vertebral body through an anterior approach for PTK in the thoracolumbar spine has several advantages large angle correction,less interruption of nerve,mini-invasion and less levels fixation.Satisfactory clinical outcome can be achieved.