New methodology for correction of lumbo-sacral kyphosis deformity in affected person with excessive pelvic incidence.
Eur Backbone J. 2017 Aug;26(eight):2204-2210
Authors: Czyz M, Forster S, Holton J, Shariati B, Clarkson DJ, Boszczyk BM
STUDY DESIGN: Technical be aware.
OBJECTIVE: We describe a novel strategy of bilateral longitudinal sacral osteotomy permitting direct discount of excessive pelvic incidence (PI) and correction of sagittal imbalance.
METHODS: A 25-year-old feminine affected person introduced with a disabling lumbo-sacral kyphosis fused in situ by earlier operations with residual low-grade wound an infection and grade IV L5/S1 spondylolisthesis with severity index (SI) of 65%. A two-stage correction was carried out. First anterior in situ fixation of the L4-L5-S1 segments was carried out utilizing a hole modular anchorages (HMA) screw and L3/L4 anterior interbody cage. The second stage consisted of instrumentation of the decrease lumbar backbone and pelvis; placement of an S1 transverse Okay-wire as pivot level and bilateral longitudinal sacral osteotomy which allowed for gradual retroversion of the central sacrum relative to the pelvis.
RESULTS: Sacrum was derotated by 30° which allowed to revive spinal sagittal stability and reduce SI by 15%. Postoperative restoration was sophisticated by a flare up of the pre-existing deep wound an infection.
CONCLUSIONS: Bilateral longitudinal sacral osteotomy seems to be a protected and environment friendly means of correcting the sagittal imbalance brought on by an especially excessive PI. Though technically demanding, it achieves good radiological and useful outcomes and avoids coming into the spinal canal.
PMID: 28688061 [PubMed – indexed for MEDLINE]