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Osteotomies in ankylosing spondylitis: where, how many, and how much?

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Abstract

Introduction

This article presents the current concepts of correction of spinal deformity in ankylosing spondylitis (AS) patients. Untreated AS can be a debilitating disease. In a few patients, disease progression results in severe spinal deformity affecting not only the thoracolumbar, but also the cervical spine. Surgery for correction in AS patients has a long history. With the advent of modern instrumentation, standardization of surgical and anesthesiologic techniques, surgical safety and corrective results could be improved and experiences from lumbar osteotomies could be transferred to the cervical spine.

Methods

This article presents the current concepts of correction of spinal deformity in AS patients. In particular, questions regarding the localization and number of osteotomies, the optimal surgical target angle as well as planning and prediction of postoperative alignment are discussed.

Results

Insight into recent technical developments, current challenges with correction and geometric analysis of center of rotation (COR) in cervical 3-column osteotomies (3CO) will be presented.

Conclusion

The article should encourage readers to improve surgical correction efficacy and provide a better understanding of correction geometry in 3CO for thoracolumbar and cervical spinal deformities.

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Authors and Affiliations

  1. Schön Klinik Nürnberg Fürth, Center for Spinal and Scoliosis Therapies, Europa-Allee 1, 90763, Fürth, Germany

    Heiko Koller, Juliane Koller & Michael Mayer

  2. Department for Orthopedics and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria

    Heiko Koller & Michael Mayer

  3. Center for Spinal Surgery, Werner-Wicker-Clinic, Bad Wildungen, Germany

    Axel Hempfing

  4. Research Office, Paracelsus Medical University Salzburg, Salzburg, Austria

    Wolfgang Hitzl

  5. Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Salzburg, Austria

    Wolfgang Hitzl

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  1. Heiko Koller
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Koller, H., Koller, J., Mayer, M. et al. Osteotomies in ankylosing spondylitis: where, how many, and how much?. Eur Spine J 27 (Suppl 1), 70–100 (2018). https://doi.org/10.1007/s00586-017-5421-z

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