Clinical Observation of Posterior Approach for Surgical Treatment of Thoracolumbar Pseudarthrosis in Ankylosing Spinal Disorders

Copyright © 2024 Elsevier Inc. All rights reserved..

OBJECTIVE: The objective of this study was to evaluate the surgical effectiveness of posterior procedure with long segment stabilization for treating thoracolumbar pseudarthrosis associated with ankylosing spinal disorders (ASDs) without anterior fusion or osteotomy.

METHODS: Twelve patients with thoracolumbar pseudarthrosis in ASD were enrolled. All patients underwent posterior long-segment stabilization procedures. In some patients, the percutaneous technique or the aid of a robot or O-arm navigation was utilized for pedicle screw implantation. The clinical results were evaluated by means of the visual analog scale and Oswestry Disability Index. Radiological outcomes were evaluated for bone fusion, anterior column defect, local kyphotic correction, and position of the pedicle screws.

RESULTS: All patients experienced effective bone fusion at the sites of pseudarthrosis. The mean operative time was 161.7 ± 57.1 minutes, and the average amount of blood loss was 305.8 ± 293.2 mL. For 6 patients who underwent surgery with the assistance of a robot or O-arm navigation, there was no statistically significant difference observed in terms of operative time and mean blood loss compared to those who used the freehand technique (P > 0.05). The visual analog scale score, Oswestry Disability Index value, and mean local kyphotic angle showed significant improvements at the final follow-up (P < 0.05). The accuracy of pedicle screw placement was 96%.

CONCLUSIONS: Posterior surgery with long-segment fixation, without anterior fusion or osteotomy, can achieve satisfactory outcomes in ASD patients with thoracolumbar pseudarthrosis. The application of percutaneous techniques, as well as the assistance of robots or navigation technique may be a good choice for the treatment of pseudarthrosis in ASD patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:183

Enthalten in:

World neurosurgery - 183(2024) vom: 15. März, Seite e963-e970

Sprache:

Englisch

Beteiligte Personen:

Ye, Zhiyuan [VerfasserIn]
Shan, Bingchen [VerfasserIn]
Wei, Xiufang [VerfasserIn]
Zhao, Xushen [VerfasserIn]
Shan, Huajian [VerfasserIn]
Zhou, Zhentao [VerfasserIn]
Dai, Jun [VerfasserIn]
Du, Shengyang [VerfasserIn]
Zhou, Xiaozhong [VerfasserIn]

Links:

Volltext

Themen:

Ankylosing spinal disorders
Journal Article
O-arm navigation
Percutaneous techniques
Pseudarthrosis
Robot
Surgical outcomes

Anmerkungen:

Date Completed 13.03.2024

Date Revised 13.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.wneu.2024.01.093

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367574160