Opening Anteriorly And Closing Posteriorly Wedge Osteotomy To Correct Thoracolumbar Kyphosis By A Single Posterior Approach

Objective To investigate the effect of Opening anteriorly and Closing posteriorly wedge osteotomy to correct thoracolumbar kyphosis by a single posterior approach.Methods From June 2015 to January 2019,a total of 30 patients with thoracolumbar spinal kyphosis was treated in our hospital.There were 18 males and 12 females.The age ranges from 26 years to 48 years(mean 34.7±6.4 years).The course of disease was range8-24 months(mean 16.7±5.0 months).All patients focus on T10-L3.The pain of the waist and back and the obvious kyphosis of the thoracolumbar segment were present before the operation.The preoperative Cobb angle of kyphosis was45°-80°(mean63.6±9.3)°.Eight cases presented with neurological compromise : Frankel B in 1 case,Frankel C in 3 cases,and Frankel D in 4.Nutrition support,patients were followed by immobilization in a brace to proper exercise.X-ray,CT are used to evaluate the extent of bone fusion postoperative regularity.Cobb angle,VAS score and neurological function recovery were compared before and after operation,and analyzed by statistical method.Results All surgeries were carried out as planned.primary healing of incision was obtained.No Incisional infection occurred.The mean follow-up was 24.6±12.1 months(from 3 months to 45 months).The patient's back pain and nerve dysfunction were recovered in varying degrees.VAS score of back pain decreased from 4-9(mean 6.1±1.6)at admission to 0-4(mean 1.7±1.1)at final follow-up.The kyphotic Cobb angle was significantly decreased to 6°-26°(21.7±3.1)° at One week after operation and to 6°-28°(24.2±2.6)° at last follow-up.Bone fusion was achieved in all cases.Conclusion Opening anteriorly and Closing posteriorly wedge osteotomy is an effective way for the correction of kyphosis caused by tuberculosis,and the clinical outcomes are good.