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Comparability of the Posterior Vertebral Column Resection With the Expandable Cage Versus the Nonexpandable Cage in Thoracolumbar Angular Kyphosis.

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Comparability of the Posterior Vertebral Column Resection With the Expandable Cage Versus the Nonexpandable Cage in Thoracolumbar Angular Kyphosis.

Clin Backbone Surg. 2017 Might;30(four):E398-E406

Authors: Lee JH, Oh HS, Choi JG

Summary
STUDY DESIGN: This was a retrospective research.
OBJECTIVE: To check the radiographic and scientific outcomes of anterior help with nonexpandable cage with these of expandable cage.
SUMMARY OF BACKGROUND DATA: The targets of surgical therapy in sufferers with thoracolumbar angular kyphosis are to enhance the neurological deficit via neural decompression, to revive the traditional alignment by correction of deformity, and to stabilize the spinal column by arthrodesis. Mesh cages have been historically used for reconstruction after corpectomy. Nevertheless, expandable cages are gaining recognition on account of some benefits over mesh cages, structural autograft or allograft, and poly-ether-ether-ketone/carbon fiber.
MATERIALS AND METHODS: We carried out a retrospective research in a consecutive collection of 42 topics with a male-to-female ratio of 15:27, a imply age of 65.three±10.9 years, and a imply follow-up interval of 36.four±7.1 months, who underwent posterior vertebral column resection at our medical establishments between 2006 and 2011. They include 32 sufferers with posttraumatic kyphosis with a imply kyphotic angle of 33.1 levels (vary, 12.2-58.1 levels) and 10 sufferers with tuberculous kyphosis with a imply kyphotic angle of 53.9 levels (vary, 22.6-126.zero levels). The imply follow-up interval was 36.four months (vary, 28-54 mo). We in contrast the scientific outcomes between the two teams primarily based on radiographic findings, neurological standing, and issues. Intervertebral heights and kyphosis on the degree of vertebral column resection had been used to measure the radiographic outcomes. Neurological final result was evaluated utilizing the modified Frankel grading system.
RESULTS: Postoperatively, the imply kyphosis angle was three.zero±10.eight and 6.7±7.2 levels (P=zero.094). At a last follow-up, these values had been four.7±10.1 and 12.three±18.9 levels within the corresponding order (P=zero.099). There have been 19 (80.zero%) and 21 (86.four%) sufferers with strong arthrodesis of grade 1. On modified Frankel grading system, all of the sufferers however one achieved enchancment. However there was no vital distinction within the grade between the two teams (P>zero.05). Additionally in our collection, there have been 12 sufferers with cage subsidence and 6 with screw loosening.
CONCLUSIONS: Nonexpandable cage and expandable cage are viable choices for anterior help; each cages permit for correction of kyphosis with good fusion charge with comparable neurological outcomes. Expandable cage is efficient for the anterior help of posterior vertebral column resection.

PMID: 28437344 [PubMed – indexed for MEDLINE]

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