European Spine Journal

, Volume 27, Issue 7, pp 1586–1592 | Cite as

Health-related quality of life in patients undergoing cervico-thoracic osteotomies for fixed cervico-thoracic kyphosis in patients with ankylosing spondylitis

  • Silviu SabouEmail author
  • Hossein Mehdian
  • Dritan Pasku
  • Luca Boriani
  • Nasir A. Quraishi
Original Article



Ankylosing spondylitis (AS) can result in severe cervico-thoracic kyphotic deformity (CTKD). Few studies have addressed the relationship between cervico-thoracic osteotomies in AS and health-related quality of life scores. The aim of this study is to evaluate the impact of cervico-thoracic osteotomy (CTO) on improving quality of life for patients with fixed CTKD.


A database of all patients who underwent a CTO for CTKD in patients with AS was created. Data entered into the database consisted of patients’ demographics and comorbidities, as well as surgical, clinical and radiological data. The outcome measures used in our study were Neck Disability Index (NDI), EuroQol 5D-5L (EQ-5D-5L) and Visual Analogue Scale. We also measured the following radiological parameters: chin-brow to vertical angle (CBVA), C7-Slope, C2–7 angle, Regional Kyphosis Angle, C2–C7 sagittal vertical axis (SVA) and C7–S1 SVA.


A total of 13 male patients with AS were included in our study. The mean age was 57.5 years (40–74); and mean follow-up was 37.6 months (12–78). Following the C7–T1 osteotomy (10 Smith Peterson Osteotomies and 3 Pedicle Subtraction Osteotomies), NDI improved from a mean of 65.54 (SD 8.95) to a mean of 22.09 (SD 6.99). The EQ-5D-5L improved from a mean of 0.41 (SD 0.16) to 0.86 (SD 0.088). Pre-operative CBVA was on average 54° (40°–75°) and post-operative was 7° (2°–12°). There were no major complications, 1 superficial infection and 5 minor nerve root irritations.


Cervical osteotomy for the management of fixed flexion deformity of cervical spine in ankylosing spondylitis is a safe procedure and can result in restoration of horizontal gaze and sagittal balance with significant improvement of the patient’s health-related quality of life.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Spinal osteotomy Ankylosing spondylitis Outcome Complications Quality of life 



The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No relevant financial activities outside the submitted work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

586_2018_5530_MOESM1_ESM.pptx (135 kb)
Supplementary material 1 (PPTX 135 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Complex Spine SurgerySalford Royal NHS Foundation TrustSalfordUK
  2. 2.Centre for Spinal Studies and SurgeryQueens Medical Centre Campus of Nottingham University Hospitals NHS TrustNottinghamUK

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