Photo Credit: Pornpak Khunatorn
The following is a summary of “One-stage Spine-shortening Osteotomy Treated Severe Spinal Deformity Associated With Spinal Cord Malformations,” published in the May 2023 issue of Spinal Disorders and Techniques by Yang et al.
Case series retrospective is the study design that is used. The objective is to evaluate the safety and efficacy of spine-shortening using 1-stage, 3-column osteotomy in patients with severe rigid spinal deformity and spinal cord malformation (SCM). A one-stage spine-shortening osteotomy has been proposed to treat a tethered spinal cord. However, the safety and effectiveness of a single-stage spine-shortening osteotomy for treating a severe spinal deformity with an SCM are unknown.
From January 2010 to December 2016, the records of 32 patients with severe spinal deformity and SCM treated with spine-shortening via 3-column osteotomy were retrospectively analyzed. All cases utilized intraoperative neurophysiological monitoring. Imaging parameters and neurological complications were examined to evaluate clinical safety and efficacy. All 32 patients underwent a successful spine-shortening procedure involving a three-column osteotomy. The mean primary coronal curve and maximal kyphotic angle were corrected by 51.4% and 54.3%, from 119.8 and 119.1 degrees to 58.6 and 53.9 degrees, respectively.
At a mean follow-up of 73.6 months, the mean correction loss of the significant coronal curve and maximum kyphosis were 2.3 and 2.6 degrees, respectively. In 9 patients, intraoperative monitoring events occurred; 3 of these 9 patients sustained transient SC injuries but recovered within one year without incurring permanent paralysis. Spine-shortening with a 3-column osteotomy is safe and effective for treating severe spinal deformity with an SCM. Intensive intraoperative neuromonitoring and a thorough comprehension of the method enhanced the safety of this challenging and complex surgical procedure.
