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Bodyline neck decompressor1/1/2024 All patients had undergone standardized axial and sagittal bone-window CT scanning at C0-T3 in a supine neutral position. The purpose of this study was, firstly, to explore the feasibility of the modified PSO technique for C7 by simulating osteotomy on computed tomography (CT) scanning, and secondly, to investigate the efficacy of the modified C7PSO technique on a series of patients with cervicothoracic kyphosis secondary to ankylosing spondylitis.Ī total of 120 cervical spine computed tomography (CT) scans (of 82 male and 38 female patients) were evaluated in this study. Therefore, based on the technique of VCD, we modified PSO by shifting the hinge of correction backwards from the anterior longitudinal ligament. However, this procedure has only been described for deformities of the thoracolumbar spine. In addition, VCD includes osteoclasis of the anterior cortex of the osteotomised vertebrae, which decreases the need for shortening of the posterior column, reducing the risk of neurological deficits. Second, a PSO can achieve a mean correction of 30–40° according to the literature, while VCD can achieve a mean correction of 83.8°. If the correction is not adequate, a retroposition of the hinge can be performed. This differs from the technique of a VCD, where the hinge of the correction is located at the border of the anterior and medial column. First, a PSO is performed using the retained anterior longitudinal ligament to act as a hinge to close the osteotomy. VCD was found to have several advantages over PSO. in a series of nine patients with severe Pott’s kyphosis. Vertebral column decancellation (VCD) is a new thoracolumbar osteotomy technique, which was first described by Wang et al. Cervical PSO includes the resection of the posterior column and a transpedicular wedge osteotomy, shortening the posterior and middle columns, without lengthening of the anterior column. Several reports described the cervical pedicle subtraction osteotomy (PSO) technique and have demonstrated that it is more stable and safer than opening wedge osteotomy. However, osteotomies in the cervical spine are technically more challenging to perform, due to the need to protect the vertebral artery and the potentially devastating consequences of a cervical level cord injury. The osteotomies that can be performed in the cervical spine are largely similar to those performed in the thoracolumbar spine. For these patients, surgical correction and osteotomies are often required. Severe and rigid cervicothoracic kyphosis in patients with ankylosing spondylitis can cause pain, myelopathy, radiculopathy, marked limitation of horizontal gaze or upright posture, swallowing dysfunction leading to aspiration, as well as social impairment. The modified PSO is a safe and valid alternative to the classic PSO, allowing for excellent correction of cervical kyphosis and improvement in health-related quality-of-life measures. No major complications occurred, and no implant failures were noted until the latest follow up. In the case series, radiographic parameters and health-related quality-of-life measures were found to show significant postoperative improvement in all patients. In this morphometric study, a modified PSO was performed on 87 patients (59 male and 28 female) with a reasonable ratio of 72.5%. The outcomes were analyzed through various measures, which included the 36-Item Short Form Health Survey (SF-36) and a visual analog scale for neck pain. Preoperative and postoperative chin-brow vertical angle (CBVA), sagittal vertical axis (SVA) and sagittal Cobb angle of the cervical region were reviewed. The mean follow up was 32.9 months (range 21–54 months). Seven patients with cervicothoracic kyphosis who underwent a modified PSO at C7 between May 2009 and June 2015 were retrospectively evaluated. Simulated osteotomy was performed by setting the apex of the wedge osteotomy at different points, and morphologic measurements were obtained. The scans were taken parallel to the middle sagittal plane and the sagittal plane intersecting the pedicles. MethodsĪ total of 120 cervical spine computed tomography (CT) scans (of 82 male and 38 female patients) were evaluated. The purpose of this study was to evaluate the feasibility of the modified pedicle subtraction osteotomy (PSO) technique at C7 to be used for the treatment of cervicothoracic kyphosis secondary to ankylosing spondylitis. Osteotomies in the cervical spine are technically challenging.
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