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Comparative Study
. 2015 Feb 3:10:23.
doi: 10.1186/s13018-015-0154-3.

Three-column osteotomy surgery versus standard surgical management for the correction of adult spinal deformity: a cohort study

Xinran Ji  1   2 , Hua Chen  3 , Yiling Zhang  4 , Lihai Zhang  5 , Wei Zhang  6 , Sigurd Berven  7 , Peifu Tang  8
Affiliations
Comparative Study

Three-column osteotomy surgery versus standard surgical management for the correction of adult spinal deformity: a cohort study

Xinran Ji et al. J Orthop Surg Res. .

Abstract

Background: The aim of this study was to analyze and compare the surgical data, clinical outcomes, and complications between three-column osteotomy (3-COS) and standard surgical management (SSM) for the treatment of adult spine deformity (ASD).

Methods: A total of 112 patients who underwent consecutive 3-COS (n = 48) and SSM (n = 64) procedures for ASD correction at a single institution from 2001 to 2011 were reviewed in this study. The outcomes were assessed using the Scoliosis Research Society (SRS)-22 scores. The complications of patients with 3-COS and SSM were also compared.

Results: No significant differences were found in patient characteristics between SSM and 3-COS groups. Surgical data and radiographic parameters showed that the patients of the 3-COS group suffered more severe ASD than those of the SSM group. The distribution of surgical complications revealed that SSM group underwent more complications than 3-COS groups with no significant differences. At final follow-up, the total SRS-22 score of SSM was not significant between pre-operation and post-operation. However, the total SRS-22 score of 3-COS at final follow-up was significantly higher than pre-operation.

Conclusion: For severe ASD patients with high grade pelvic incidence (PI), pelvic tilt (PT), and PI/lumbar lordosis (LL) mismatch and who have subjected to spine surgeries more than twice before, 3-COS might be more effective than SSM in improving the clinical outcomes. However, due to the higher reoperation rate of 3-COS, SSM may be more appropriate than SSM for correcting the not serious ASD patients.

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Figures

Figure 1
Figure 1
Two 63- and 79-year-old women suffering from adult spinal deformity underwent 3-column osteotomy (A) and standard surgical management (B), respectively. Three years after surgery, anteroposterior and lateral radiographs demonstrate marked correction, satisfactory alignment, and a solid spinal fusion.
See this image and copyright information in PMC

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