Document Detail

Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy.
MedLine Citation:
PMID:  19763635     Owner:  NLM     Status:  MEDLINE    
This is a radiographic study of ankylosing spondylitis patients with severe fixed kyphotic deformity who underwent pedicle subtraction osteotomy. Our goal was to measure and validate new angle to assess global kyphosis and to evaluate the radiological outcomes after surgery. This is the first report which describes new angle to assess global kyphosis (T1-S1). Pre and postoperative controls were compared according to the Pelvic Incidence. The sagittal parameters ankylosing spondylitis patients were compared with 154 asymptomatic patients. In addition to the pelvic parameters and the C7 tilt, we used the spino-sacral angle. Pelvic incidence in ankylosing spondylitis patients was higher than asymptomatic population (61 vs. 51 degrees). For a same tilt of C7 for both groups, the low pelvic incidence group had a lower sacral slope and pelvic tilt and a higher global kyphosis (spino-sacral angle = 90 degrees) than the high pelvic incidence group (spino-sacral angle = 98 degrees ). In the adult volunteers, the C7 tilt and spino-sacral angle measured, respectively, 95 and 135 degrees. The preoperative C7 tilt measured 73 degrees and increased to 83 degrees (p = 0.0025). The preoperative spino-sacral angle measured 96 degrees and increased to 113.3 degrees (p = 0.003). A low pelvic incidence pelvis has a lower sacral slope than in high pelvic incidence and can support a bigger kyphosis. All the parameters were improved by the pedicle subtraction osteotomy, but the average spino-sacral angle remained lower than the control group. When C7 tilt was useful to assess the improvement of the balance, SSA allowed a better evaluation of the correction of kyphosis itself.
Romain Debarge; Guillaume Demey; Pierre Roussouly
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Publication Detail:
Type:  Journal Article     Date:  2009-09-11
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  19     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-05-04     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  65-70     Citation Subset:  IM    
The Department of Orthopedic Surgery, Centre des Massues, Lyon, France.
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MeSH Terms
Cohort Studies
Disability Evaluation
Kyphosis / pathology,  radiography*,  surgery
Middle Aged
Outcome Assessment (Health Care) / methods*
Pelvis / pathology,  radiography
Radiology / methods*
Sacrum / pathology,  radiography
Severity of Illness Index
Spine / pathology,  radiography*,  surgery
Spondylitis, Ankylosing / pathology,  radiography*,  surgery
Young Adult

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