Portal de Periódicos da CAPES

Functional Outcome and Radiographic Correction After Spinal Osteotomy

2002; Lippincott Williams & Wilkins; Volume: 27; Issue: 12 Linguagem: Inglês

10.1097/00007632-200206150-00011

1528-1159

Uri M. Ahn, Nicholas U. Ahn, Jacob M. Buchowski, Khaled M. Kebaish, Ji Ho Lee, Edward Song, Mesfin Lemma, Ann N. Sieber, John P. Kostuik,

Spinal Fractures and Fixation Techniques

Study Design. A prospective clinical trial to study the radiographic parameters and functional outcome in patients undergoing spinal osteotomy. Objectives. To determine whether correction of specific radiographic parameters is associated with improved functional outcome. Summary of Background Data. Although vertebral osteotomies have been shown to improve functional outcome in patients with spinal deformity, no prospective reports have studied whether correction of specific radiographic parameters is associated with improvement in functional outcome. Methods. Eighty-three patients with fixed sagittal and/or coronal deformity were followed over a 7-year period. Patients were evaluated clinically and radiographically and completed a SF-36 Health Survey and American Academy of Orthopedic Surgeons Modems Instrument questionnaire. Spearman correlation analysis was used to determine the association between correction of radiographic parameters and functional outcome. Results. Mean preoperative lumbar lordosis measured −14.2° (i.e., kyphosis) with an average postoperative correction of 27.9°. Mean preoperative lumbar scoliosis measured 40.1° with an average postoperative correction of 15.1°. Mean preoperative plumb sagittal and coronal plane alignment was 8.37 cm and 4.22 cm, respectively; after surgery they improved to 3.33 cm and 2.31 cm, respectively. A significant association was found between sagittal angular correction and physical function (P = 0.034) and role–physical (P = 0.01) when postoperative lumbar lordosis was >25°. A significant association was also found between plumb coronal correction and physical function (P = 0.041), vitality (P = 0.05), and social function (P = 0.047) when postoperative plumb coronal alignment was 25° and if postoperative plumb coronal alignment was <2.5 cm. Therefore, these radiographic parameters should be the goal of a spinal osteotomy. The surgery has a relatively high complication rate.