Surgical Treatment of Angular Pott's Kyphosis with Posterior Approach, Pedicular Wedge Osteotomy and Canal Widening.

Autor:	Kinkpe CV; Faculté de Médecine, Pharmacie et Odontologie de l'Université Cheikh Anta DIOP, Dakar, Sénégal.; Centre Hospitalier de l'Ordre de Malte (CHOM), Dakar, Sénégal., Onimus M; 8 chemin du cret F-25240 GELLIN, France., Sarr L; Faculté de Médecine, Pharmacie et Odontologie de l'Université Cheikh Anta DIOP, Dakar, Sénégal., Niane MM; UFR Santé de Thiès, Sénégal.; Centre Hospitalier de l'Ordre de Malte (CHOM), Dakar, Sénégal., Traore MM; Faculté de Médecine, Pharmacie et Odontologie de l'Université Cheikh Anta DIOP, Dakar, Sénégal.; Centre Hospitalier de l'Ordre de Malte (CHOM), Dakar, Sénégal., Daffe M; Faculté de Médecine, Pharmacie et Odontologie de l'Université Cheikh Anta DIOP, Dakar, Sénégal.; Centre Hospitalier de l'Ordre de Malte (CHOM), Dakar, Sénégal., Gueye AB; Faculté de Médecine, Pharmacie et Odontologie de l'Université Cheikh Anta DIOP, Dakar, Sénégal.; Centre Hospitalier de l'Ordre de Malte (CHOM), Dakar, Sénégal.
Jazyk:	angličtina
Zdroj:	The open orthopaedics journal [Open Orthop J] 2017 Mar 31; Vol. 11, pp. 274-280. Date of Electronic Publication: 2017 Mar 31 (Print Publication: 2017).
DOI:	10.2174/1874325001711010274
Abstrakt:	Background: It has been observed that the correction of severe posttuberculous angular kyphosis is still a challenge, mainly because of the neurologic risk. Methods: Nine patients were reviewed after surgery (mean follow-up 18 months). There were 2 thoracic, 4 thoraco-lumbar and 3 lumbar kyphosis. The mean age at surgery was 23. Clinical results were evaluated by the Oswestry Disability Index (ODI) and by the neurologic evaluation. Preoperative, postoperative and final follow-up X-rays were assessed. The surgery included a posterior approach with cord release and correction by transpedicular wedge osteotomy and widening of the spinal canal. Results: Average kyphotic angulation was 72° before surgery, 10° after surgery and 12° at follow-up. Three out of four patients with neural deficit showed improvement. Neurologic complications included a transitory quadriceps paralysis, likely by foraminal compression of the root. Conclusion: A posterior transpedicular wedge osteotomy allows a substantial correction of the kyphosis, more by deflexion than by elongation, with limited neurologic risks. However it is mandatory to widely enlarge the spinal canal on the levels adjacent to the osteotomy, in order to allow the dura to expand backwards.
Databáze:	MEDLINE
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