| A Safe Controlled Instrumented Reduction Technique for Cervical Osteotomy in Ankylosing Spondylitis. | |
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MedLine Citation:
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PMID: 21289582 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT: Study design: A retrospective review of clinical and radiological outcome in 13 consecutive patients with Ankylosing Spondylitis (AS) who underwent cervical osteotomy for correction of fixed cervicothoracic kyphotic deformity (CTKD) using an innovative technique.Objective: To report further refinements to an existing technique for instrumented reduction of cervical osteotomy and assess the safety and efficacy of this procedure in 13 patients.Summary of Background data: Cervical osteotomy in AS has been used for correction of CTKD, but is associated with significant risks. We have previously reported a novel technique to perform this procedure safely . Even with this technique there was a small risk of subluxation and this risk has been further reduced with our new technique.Methods: Between 1993- 2008, the senior author (SHM) performed cervical osteotomy for severe CTKD in 13 AS patients. There were 11 male and 2 female patients, the average age being 56 (40-74) years. The main surgical indication was restricted frontal visual field. The average symptom duration was 2.7(1-5) years. All patients had a general anaesthetic underwent cervical osteotomy and instrumentation from C3-T5 in prone position.Results: The average duration of surgery was 4.7 (3 to 6.5) hours. The calculated blood loss was 1938 (1000 - 3600) mls. The mean follow-up period was 6.5 (1.5 -16) years. The mean pre-op chin brow vertical angle (CBVA) was found to be 54 (20 to 70) degrees. Post-operatively this improved to 7 (2-12) degrees. The pre-op Kyphotic angle measured 19.2 (14-28). This improved post - operatively to - 34 (-21 to -39) degrees. There were no instances of neurological deficit. At a mean follow-up of 6.5 years (18m -16 years), no instances of loss of correction or implant failure were noted.Conclusion: This innovative new technique provides for a safe controlled reduction for cervical osteotomy for fixed cervico-thoracic kyphosis in AS. The technique reliably renders rigid immobilisation which obviates the risk of intra- and post-operative junctional subluxation, eliminates the need for post-operative halo-vest immobilisation and achieves satisfactory fusion. |
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Authors:
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Smh Mehdian; R Arun |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-1 |
Journal Detail:
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Title: Spine Volume: - ISSN: 1528-1159 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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# - Senior Consultant Spine Surgeon, Centre for Spinal Studies and Surgery, Nottingham Univeristy Hospital NHS Trust * - Specialist Registrar, Northern Deanery. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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