Wei Zhang1,2,3, Hai-Yang Yu4,5, Hong-Liang Wang2,3, Guo-Hui Zheng2,3, Yun-Lei Zhai2,3, Xi-Long Cui2,3, Ji-Shi Jiang2,3, Jian-Xiang Zhang1, Cai-Liang Shen6, Yichen Wang7. 1. Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China. 2. Spinal Deformity Clinical Medichine and Research Center of Anhui Province, 501 Sanqing Road, Fuyang, 236000, Anhui, China. 3. Department of Orthopedics, Fuyang People's Hospital, 501 Sanqing Road, Fuyang, 236000, Anhui, China. 4. Spinal Deformity Clinical Medichine and Research Center of Anhui Province, 501 Sanqing Road, Fuyang, 236000, Anhui, China. fy.yhy@163.com. 5. Department of Orthopedics, Fuyang People's Hospital, 501 Sanqing Road, Fuyang, 236000, Anhui, China. fy.yhy@163.com. 6. Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China. shencailiang1616@163.com. 7. Mercy Medical Center, Trinity Health of New England, 271 Carew Street, Springfield, MA, 01104, USA.
Abstract
PURPOSE: This study aims to introduce an innovative adjustable prone positioning frame (APPF) and explore its feasibility and safety for treatment of severe kyphosis secondary to ankylosing spondylitis (AS) with two-level osteotomy. METHODS: A retrospective, non-controlled study was conducted to illustrate the process where 13 patients diagnosed with severe kyphosis secondary to AS received operations on the APPF. Parameters of chin brow vertical angle (CBVA), global kyphosis (GK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL) and sagittal vertical axis (SVA) were measured. Positioning time, operation time, intraoperative blood loss aḥd complications were also determined. The Scoliosis Research Society outcomes instrument (SRS-22) was applied for clinical assessment. RESULTS: All patients were placed on the APPF successfully with the positioning time of 2.92 ± 0.76 min, received operation with 457.00 ± 88.04 min and had blood loss of 2330.77 ± 1423.25 ml. Four cases experienced pain due to tensional skin of the abdomen and one case suffered cerebrospinal fluid leakage postoperatively, but these patients were all cured conservatively. No neurological complications were observed, although sagittal translation occurred in four patients. Significant improvements were detected in CBVA, GK, TLK, LL and SVA postoperatively (P < 0.05), but no significant difference was observed between postoperation and the final follow-up (P > 0.05). The SRS-22 scores at 2 years after operation were significantly higher than those before operation (P < 0.05). CONCLUSION: The innovative APPF provided great convenience to place patients with severe kyphosis secondary to AS in a prone position. Performing two-level osteotomy with the aid of APPF is safe, feasible and effective.
PURPOSE: This study aims to introduce an innovative adjustable prone positioning frame (APPF) and explore its feasibility and safety for treatment of severe kyphosis secondary to ankylosing spondylitis (AS) with two-level osteotomy. METHODS: A retrospective, non-controlled study was conducted to illustrate the process where 13 patients diagnosed with severe kyphosis secondary to AS received operations on the APPF. Parameters of chin brow vertical angle (CBVA), global kyphosis (GK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL) and sagittal vertical axis (SVA) were measured. Positioning time, operation time, intraoperative blood loss aḥd complications were also determined. The Scoliosis Research Society outcomes instrument (SRS-22) was applied for clinical assessment. RESULTS: All patients were placed on the APPF successfully with the positioning time of 2.92 ± 0.76 min, received operation with 457.00 ± 88.04 min and had blood loss of 2330.77 ± 1423.25 ml. Four cases experienced pain due to tensional skin of the abdomen and one case suffered cerebrospinal fluid leakage postoperatively, but these patients were all cured conservatively. No neurological complications were observed, although sagittal translation occurred in four patients. Significant improvements were detected in CBVA, GK, TLK, LL and SVA postoperatively (P < 0.05), but no significant difference was observed between postoperation and the final follow-up (P > 0.05). The SRS-22 scores at 2 years after operation were significantly higher than those before operation (P < 0.05). CONCLUSION: The innovative APPF provided great convenience to place patients with severe kyphosis secondary to AS in a prone position. Performing two-level osteotomy with the aid of APPF is safe, feasible and effective.
Authors: Douglas S M Iaboni; Mark E Seamone; Mary S Stairs; Daniel M OʼBrien; M Sheldon Bisson; R Rishi Gupta Journal: Retin Cases Brief Rep Date: 2019
Authors: Daniel M Sciubba; Clarke Nelson; Patrick Hsieh; Ziya L Gokaslan; Steve Ondra; Ali Bydon Journal: Neurosurg Focus Date: 2008 Impact factor: 4.047