The Efficacy Of Single-level Osteotomy For Congenital Malformation Typed Kyphoscoliosis

ObjectiveTo evaluate the efficacy of single-level osteotomy in the treatment ofmalformation typed congenital kyphoscoliosis (CKS).Methods19consecutive cases of malformation typed CKS patients from July2006to May2012with single-level osteotomy and posterrior pedicle screwfixation were investigated retrospectively, in which,9cases wereconducted by pedicle subtraction osteotomy (PSO),10cases wereconducted by vertebra column resection (VCR), the average age was19.2years, the average follow-up time was4.2years. The surgical andradiographic information were comparative analysised, the VisualAnalogue Scale (VAS), the American Spinal Injury Association(ASIA)classification and the complications along follow-up time were reviewed.ResultsMean operative time was302.1±43.2min with average blood loss of589.5±151.5ml and average fusion segment of6.0±1.5. The correctionrates of scoliosis Cobb’s angle, segmental kyphosis Cobb’s angle anddistance of vertical line between the7th vertebra and central sacra (C7-CSL)were79.7%±9.2%,81.1%±21.9%,82.7%±12.5%, respectively. The parameters above were not significantly different (p>0.05) between PSOgroup and VCR group except the preoperative segmental kyphosis Cobb’sangle, of which, PSO group was22.7°±22.0°, VCR group was62.2°±21.0°, p=0.001. At last follow-up, no significant progresses wereobserved in scoliosis Cobb’s angle, segmental kyphosis Cobb’s angle andC7-CSL, the VAS decrese rate was85.9%±15.9%,3cases of D in ASIAclassification were improved to E. There were1cerebrospinal fluid leakage,2unilateral numbness and1back pain, without any sign of wound infectionor implant failure.ConclusionSingle-level osteotomy with posterior pedicle screw fixation is safeand feasible, and excellent correction can be obtained. For sagittalcorrection, VCR procedure shows a significant advantage.