Surgical therapy of thoraco-lumbar kyphosis (TLK) related to low pelvic incidence.
Eur Backbone J. 2017 Aug;26(Eight):2146-2152
Authors: Scemama C, Laouissat F, Abelin-Genevois Okay, Roussouly P
PURPOSE: Thoraco-lumbar kyphosis (TLK) is poorly described within the literature and its surgical therapy stays equivocal for sufferers with low pelvic incidence. The intention of the research was to establish which surgical correction would yield the very best useful outcomes as measured by the Oswestry rating.
MATERIALS AND METHODS: This can be a retrospective research together with sufferers described as a sort 1 of Roussouly’s classification with a thoraco-lumbar kyphosis. Fifty-six sufferers with degenerative spinal illness had been included, 42 (75%) with scoliosis and 14 (25%) with out. Sufferers had a median age of 56 years (49-63), and there have been 6 (11%) males. The first consequence was the useful Oswestry incapacity index (ODI).
RESULTS: Eventually follow-up, the median ODI was 15 (Q1-Q3: 6-23). Within the degenerative spinal illness group, the median ODI was 7 (three.5-20) ultimately follow-up. Ten (84%) sufferers had been labeled as Roussouly’s sort 1 after surgical procedure. Within the degenerative scoliosis group, the ODI was 17 (Eight-23) in sufferers labeled as Roussouly’s sort 1 and 20 (7.5-25) in sufferers labeled as Roussouly’s sort 2 with no vital distinction between these teams (p = 1). There have been two sufferers labeled as Roussouly’s sort 3a and their ODI ultimately follow-up had been of 60 and 50.
CONCLUSION: It appears that evidently retaining the physiological morphology is the therapy of selection. For sufferers with degenerative scoliosis, lowering the kyphosis might work. We don’t advocate to extend the lordosis and procure a sort three morphology with an anteverted pelvis due to the danger of PJK and poor useful outcomes.
PMID: 28180982 [PubMed – indexed for MEDLINE]