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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Funding

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.

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Authors and Affiliations

  1. Department of Complex Spine Surgery, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK

    Silviu Sabou

  2. Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK

    Hossein Mehdian, Dritan Pasku, Luca Boriani & Nasir A. Quraishi

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  1. Silviu Sabou
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  2. Hossein Mehdian
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Correspondence to Silviu Sabou.

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Sabou, S., Mehdian, H., Pasku, D. et al. Health-related quality of life in patients undergoing cervico-thoracic osteotomies for fixed cervico-thoracic kyphosis in patients with ankylosing spondylitis. Eur Spine J 27, 1586–1592 (2018). https://doi.org/10.1007/s00586-018-5530-3

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