Document Detail

Effectiveness of preoperative planning in the restoration of balance and view in ankylosing spondylitis.
MedLine Citation:
PMID:  18290745     Owner:  NLM     Status:  MEDLINE    
OBJECT: The object of this study was to assess the effectiveness of preoperative planning in the restoration of balance and view angle in patients treated with lumbar osteotomy in ankylosing spondylitis (AS). METHODS: The authors prospectively analyzed 8 patients with a thoracolumbar kyphotic deformity due to AS that was treated using a closing wedge osteotomy (CWO) of the lumbar spine to correct sagittal imbalance and horizontal view. Preoperative planning to predict postoperative balance, defined by the sagittal vertical axis (SVA) and the sacral endplate angle (SEA), and the view angle, defined by the chin-brow to vertical angle (CBVA), was performed using the ASKyphoplan computational program. RESULTS: All patients were treated with a CWO at level L-4 and improved in balance and view angle. The mean correction angle was 35 degrees (range 24-47 degrees). The postoperative SEA improved from 21 to 36 degrees for a mean correction of 15 degrees . In addition, the SVA and CBVA improved significantly. Note, however, that the postoperative results did not exactly reflect the predicted values of the analyzed parameters. CONCLUSIONS: Preoperative planning for the restoration of balance and view angle in AS improves understanding of the biomechanical and clinical effects of a correction osteotomy of the lumbar spine. The adaptation of basic clinical and biomechanical principles to restore balance is advised in such a way that the individual SEA is corrected by 15 degrees (maximum 40 degrees ) in relation to the horizon and C-7 is balanced exactly above the posterosuperior corner of the sacrum.
Roy R Pigge; Famke J Scheerder; Theo H Smit; Margriet G Mullender; Barend J van Royen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgical focus     Volume:  24     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-22     Completed Date:  2008-04-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E7     Citation Subset:  IM    
Department of Orthopaedic Surgery, VU University Medical Centre, Amsterdam, The Netherlands.
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MeSH Terms
Follow-Up Studies
Lumbar Vertebrae*
Middle Aged
Osteotomy / methods*
Postural Balance / physiology
Preoperative Care
Prospective Studies
Recovery of Function / physiology
Spondylitis, Ankylosing / physiopathology,  surgery*
Surgery, Computer-Assisted*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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