Radiological and Clinical Outcomes after Surgical Correction of Post-traumatic Kyphosis by multiple Ponte osteotomies

Abstract

Background data: Kyphotic spine deformity is a major problem that may affect wellbeing the patients. We aimed to determine the degree of spinopelvic parameters correction after multiple Ponte osteotomies of malunited vertebrae and clinical improvement of the patients postoperatively. Methods: A retrospective cohort study of a total of 17 patients with posttraumatic kyphosis included in this study. The average age was 25.0 ± 7.44 (range 18-38) with 10 females and 7 males. Patients were treated with multiple Ponte osteotomies. Plain radiography, CT, and MRI were performed on all patients, and the following parameters were measured using the Surgimap (version: 2.2.13) computer program: Thoracic kyphosis (TK), Lumbar lordosis (LL), Pelvic incidence (PI), Sacral slope (SS), Pelvic tilt (PT) and Sagittal vertical axis (SVA). Bony fusion is assessed using postoperative radiograph. VAS score for pain and the ODI were assessed preoperatively and at the last follow up. Results: The average follow-up period was 21.20 ± 6.37 (range 17–23 months). VAS score decreased from (6.20 ± 1.77) preoperatively to (3.3 ± 0.60) postoperatively while the ODI score showed significant decrease from (34.0±12.03) preoperatively to (19.40±1.90) postoperatively. The local kyphotic angle decreased from 51.60±8.76 to 15.01± 6.97. The mismatch between pelvic incidence and lumbar lordosis declined from 17.30 ± 6.98 to 8.60 ± 2.55. The lumbar lordosis showed significant change from 61.44 ± 14.24 to 47.40 ± 9.16. Conclusion: Multiple Ponte Osteotomies provides significant correction of pelvic parameters and clinical functions of patients with fixed posttraumatic deformity.