Skip to main content

Advertisement

SpringerLink
Log in

Spinal osteotomies to treat post-traumatic thoracolumbar deformity

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Fractures of the thoracolumbar junction can lead to regional kyphosis, this being a significant cause of pain and disability for the patients. After a traumatic fracture of the thoracolumbar spine, early or late regional kyphosis can be observed. This post-traumatic deformity can, however, be corrected with appropriate surgical methods. Posterior tricolumnar osteotomies are some of the most powerful methods of correction and are particularly indicated when sagittal and coronal deformities have to be simultaneously corrected or when anterior surgery is not possible. Anterior corpectomy and lengthening with posterior instrumentation are, however, an alternative technique to restore the anterior column support and to correct the regional kyphotic deformity and an option for appropriate sagittal balance restoration and control of symptoms. Proper surgical technique, evaluation of the bone quality and identification of eventual extension of the deformity to the thoracic spine are key aspects in prevention of failures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Tay BKB, Eismont F (2002) Cervical spine fractures and dislocations. In: Fardon DF, Garfin SR, Abitbol JJ, et al. (eds) Orthopaedic knowledge update: spine 2. Rosemont, IL Am Acad Orthop Surg 247–62

  2. Vaccaro AR, Jacoby SM (2002) Thoracolumbar fractures and dislocations. In: Fardon DF, Garfin SR, Abitbol JJ, et al. (eds) Orthopaedic knowledge update: spine 2. Rosemont, IL Am Acad Orthop Surg 263–78

  3. Buchowski JM, Kuhns CA, Bridwell KH, Lenke LG (2008) Surgical management of posttraumatic thoracolumbar kyphosis. Spine J 8:666–677

    Article  PubMed  Google Scholar 

  4. Polly DW Jr, Klemme WR, Shawen S (2000) Management options for the treatment of posttraumatic thoracic kyphosis. Semin Spine Surg 12:110–116

    Google Scholar 

  5. Vaccaro AR, Silber JS (2001) Post-traumatic spinal deformity. Spine 26:S111–S118

    Article  CAS  PubMed  Google Scholar 

  6. Knop C, Fabian HF, Bastian L et al (2001) Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting. Spine 26:88–99

    Article  CAS  PubMed  Google Scholar 

  7. Shen WJ, Liu TJ, Shen YS (2001) Nonoperative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurological deficit. Spine 26:1038–1045

    Article  CAS  PubMed  Google Scholar 

  8. Malcolm BW, Bradford DS, Winter RB et al (1981) Post-traumatic kyphosis. J Bone Joint Surg Am 63:891–899

    CAS  PubMed  Google Scholar 

  9. Young WF, Brown D, Kendler A, Clements D (2002) Delayed posttraumatic osteonecrosis of a vertebral body (Kummell’s disease). Acta Orthop Belg 68:13–19

    CAS  PubMed  Google Scholar 

  10. Chou LH, Knight RQ (1997) Idiopathic avascular necrosis of a vertebral body: case report and literature review. Spine 22:1928–1932

    Article  CAS  PubMed  Google Scholar 

  11. Bolesta MJ, Bohlmann HH (1991) Late sequel of thoracolumbar fractures and fracture-dislocations. In: Frymoyer JW (ed) The Adult Spine Principles and Practice. Raven Press, New York, pp 1331–1352

    Google Scholar 

  12. Gertzbein SD, Harris MB (1992) Wedge osteotomy for the correction of post-traumatic kyphosis. Spine 17:374–379

    Article  CAS  PubMed  Google Scholar 

  13. Roberson JS, Whitesides TE (1985) Surgical reconstruction of late posttraumatic thoracolumbar kyphosis. Spine 10:307–312

    Article  CAS  PubMed  Google Scholar 

  14. Bordbelt AR, Stoodley MA (2003) Post-traumatic syringomyelia: a review. J Clin Neurosci 10:401–408

    Article  Google Scholar 

  15. Roosier AB, Foo D, Shillito J, Dyro FM (1985) Posttraumatic cervical syringomyelia. Incidence, clinical presentation, electrophysiologic studies, syrinx protein and results of conservative and operative treatment. Brain 108:439–461

    Article  Google Scholar 

  16. Gertzbein SD (1992) Scoliosis research society: multicenter spine fracture study. Spine 17:528–540

    Article  CAS  PubMed  Google Scholar 

  17. Roberson JR, Whitesides TE Jr (1985) Surgical reconstruction of late posttraumatic thoracolumbar kyphosis. Spine 10:307–312

    Article  CAS  PubMed  Google Scholar 

  18. Bridwell KH (2006) Decision making regarding Smith-Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine 31(19 Suppl.):S171–S178

    Article  PubMed  Google Scholar 

  19. Kim YJ, Bridwell KH, Lenke LG et al (2007) Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance. a minimum 5-year follow-up study. Spine 32:2189–2197

    Article  PubMed  Google Scholar 

  20. Chou D, Wang VY, Storm PB (2010) Pedicle subtraction osteotomies for the correction of post-traumatic thoracolumbar kyphosis. J Clin Neurosci 17:113–117

    Article  PubMed  Google Scholar 

  21. Bridwell KH, Lewis SJ, Edwards C et al (2003) Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine 28:2093–2101

    Article  PubMed  Google Scholar 

  22. Bridwell KH, Lewis SJ, Lenke LG, Baldus C, Blanke K (2003) Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am 85:454–463

    PubMed  Google Scholar 

  23. Ahn UM, Ahn NU, Buchowski JM et al (2002) Functional outcome and radiographic correction after spinal osteotomy. Spine 27:1308–1311

    Google Scholar 

  24. Kostuik JP, Matsusaki H (1989) Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis. Spine 14:379–386

    Article  CAS  PubMed  Google Scholar 

  25. Bohlman HH, Kirkpatrick JS, Delamarter RB et al (1994) Anterior decompression for late paralysis after fractures of the thoracolumbar spine. Clin Orthop Relat Res 300:24–29

    PubMed  Google Scholar 

  26. Farcy JP, Weidenbaum M, Glassman SD (1990) Sagittal index in management of thoracolumbar burst fractures. Spine 15:958–965

    Article  CAS  PubMed  Google Scholar 

  27. Berjano P, Damilano M, Lamartina C (2012) Sagittal alignment correction and reconstruction of lumbar post-traumatic kyphosis via MIS lateral approach. Eur Spine J 21(12):2718–2720

    Article  PubMed Central  PubMed  Google Scholar 

  28. Munting E (2010) Surgical treatment of post-traumatic kyphosis in the thoracolumbar spine: indications and technical aspects. Eur Spine J 19(Suppl 1):S69–S73

    Article  PubMed  Google Scholar 

  29. Been HD, Poolman RW, Ubags LH (2004) Clinical outcome and radiographic results after surgical treatment of post-traumatic thoracolumbar kyphosis. Eur Spine J 13:101–107

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Cho KJ, Lenke LG, Bridwell KH et al (2009) Selection of the optimal distal fusion level in posterior instrumentation and fusion for thoracic hyperkyphosis: the sagittal stable vertebra concept. Spine 34:765–770

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. 2nd Division of Spine Surgery, IRCCS Istituto Ortopedico Galeazzi, via R. Galeazzi, 4-20161, Milan, Italy

    R. Cecchinato & C. Lamartina

  2. 4th Division of Spine Surgery, IRCCS Istituto Ortopedico Galeazzi, via R. Galeazzi, 4-20161, Milan, Italy

    P. Berjano & M. Damilano

Authors
  1. R. Cecchinato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Berjano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Damilano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Lamartina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Lamartina.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cecchinato, R., Berjano, P., Damilano, M. et al. Spinal osteotomies to treat post-traumatic thoracolumbar deformity. Eur J Orthop Surg Traumatol 24 (Suppl 1), 31–37 (2014). https://doi.org/10.1007/s00590-014-1464-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-014-1464-6

Keywords

Search

Navigation