Spinopelvic Balance Restoration Using Posterior Vertebral Column Resection in Fixed Lumbosacral Deformity Following Pyogenic Spondylodiscitis

Faculty Medicine Year: 2021
Type of Publication: ZU Hosted Pages:
Authors:
Journal: EGYPTIAN SPINE JOURNAL EGYPTIAN SPINE JOURNAL Volume:
Keywords : Spinopelvic Balance Restoration Using Posterior Vertebral    
Abstract:
To determine the degree of spinopelvic parameters correction after PVCR of L5 in fixed lumbosacral deformities secondary to pyogenic spondylodiscitis and defining its relation to patients` clinical and functional outcomes. Methods Retrospective study included 12 patients with fixed kyphotic lumbopelvic spinal deformity secondary to healed pyogenic spondylodiscitis of lumbosacral junction. The study included 7 males (58.3%) and 5 females (41.7%) with mean age 37.5 ± 7.61 years. Patients were treated with posterior-only vertebral column resection PVCR. Visual Analogue Scale (VAS) for both leg and back pain and the Oswestry Disability Index (ODI) were assessed. preoperatively and at the last follow up. Plain X-Ray, computed tomography (CT) and Magnetic Resonance Imaging (MRI) were done to all patients and the following parameters were measured using the Surgimap (version: 2.2.13) computer program; LL, PI, PT, SS, focal deformity angle. Bony fusion is assessed using postoperative x rays and/or CT. Results Follow-up period 16 months (12-18). Solid union was achieved in all patients in 8.17 ± 1.52 months. No major post-operative complications. The mean kyphotic deformity was significant corrected to -5.69° ± 6.77 (p<0.001). Lumbar lordosis significantly increased to 47.89°±3.37) (p<0.001). PT decreased significantly to 17.88° ±4.132, and SS increased from to 41.13°±4.01. The PI-LL mismatch was corrected to 11.1 ±4.2 in the final follow up (p<0.001). Oswestry disability index (ODI) improved to 22.50±3.20 postoperatively (p<0.001) Conclusion PVCR provides significant correction of pelvic parameters and clinical functions of patients with fixed lumbosacral deformities secondary to pyogenic spondylodiscitis.
   
     
 
       

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