Surgical Treatment of Angular Pott’s Kyphosis with Posterior Approach, Pedicular Wedge Osteotomy and Canal Widening
CV Kinkpe1, 4, *, M Onimus2, L Sarr1, MM Niane3, 4, MM Traore1, 4, M Daffe1, 4, AB Gueye1, 4
1 Faculté de Médecine, Pharmacie et Odontologie de l’Université Cheikh Anta DIOP, Dakar, Sénégal
2 8 chemin du cret F-25240 GELLIN, France
3 UFR Santé de Thiès, Sénégal
4 Centre Hospitalier de l’Ordre de Malte (CHOM), Dakar, Sénégal
It has been observed that the correction of severe posttuberculous angular kyphosis is still a challenge, mainly because of the neurologic risk.
Nine patients were reviewed after surgery (mean follow-up 18 months). There were 2 thoracic, 4 thoraco-lumbar and 3 lumbar kyphosis. The mean age at surgery was 23.
Clinical results were evaluated by the Oswestry Disability Index (ODI) and by the neurologic evaluation. Preoperative, postoperative and final follow-up X-rays were assessed.
The surgery included a posterior approach with cord release and correction by transpedicular wedge osteotomy and widening of the spinal canal.
Average kyphotic angulation was 72° before surgery, 10° after surgery and 12° at follow-up. Three out of four patients with neural deficit showed improvement. Neurologic complications included a transitory quadriceps paralysis, likely by foraminal compression of the root.
A posterior transpedicular wedge osteotomy allows a substantial correction of the kyphosis, more by deflexion than by elongation, with limited neurologic risks. However it is mandatory to widely enlarge the spinal canal on the levels adjacent to the osteotomy, in order to allow the dura to expand backwards.
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* Address correspondence to this author at the Faculté de Médecine, Pharmacie et Odontologie de l’Université Cheikh Anta DIOP, Dakar, Sénégal; Tel: 00 221 77 450 26 46; E-mail: firstname.lastname@example.org