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Case Reports
. 2021 Dec 3:13:275-280.
doi: 10.2147/ORR.S342365. eCollection 2021.

Effectiveness of Kyphosis Reduction Using Cantilever Method in Thoracolumbar Spondylitis Tuberculosis: A Short-Term Follow-Up

Didik Librianto  1 , Ismail Hadisoebroto Dilogo  2 , Achmad Fauzi Kamal  2 , Ifran Saleh  2 , Fachrisal Ipang  1 , Dina Aprilya  2
Affiliations
Case Reports

Effectiveness of Kyphosis Reduction Using Cantilever Method in Thoracolumbar Spondylitis Tuberculosis: A Short-Term Follow-Up

Didik Librianto et al. Orthop Res Rev. .

Abstract

Background: Kyphosis in spondylitis tuberculosis (STb) is more than just a cosmetic issue. It has a potentially detrimental effect on both spine-associated structures and cardiopulmonary function. It can be corrected in any stage of STb; however, the corrective surgery is challenging, especially in the late case, in which the additional stiffness of the spine can come into consideration. To date, the cantilever technique is still a gold standard for sagittal plane deformity correction. However, no study to date has explored its effectiveness for thoracolumbar kyphotic deformity, especially that caused by spondylitis tuberculosis.

Methods: This is a retrospective study of 16 consecutive cases of spondylitis tuberculosis with thoracolumbar kyphosis that underwent corrective surgery in our center in the period of 2020-2021. We aim to evaluate the effectiveness of the cantilever technique that we use for kyphotic correction in thoracolumbar STb patients.

Results: At the 3-months follow-up, the mean Cobb angle was 14.6°±10.27°, with the mean gain of 20.90°±12.00° and positively correlate with the thoracolumbar kyphosis (TLK) correction (68.69%, r = 0.654, p = 0.001). The mean thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were 30.6°±13.08°, 39.4°±16.02°, and 1.4±4.09 cm, respectively, with sagittal Cobb difference of 12.70±9.85.

Conclusion: The kyphotic Cobb angle reduction by cantilever technique in the thoracolumbar area significantly improved the thoracolumbar kyphosis and realign the spinal sagittal axis. Thus, the cantilever technique remains the gold standard for sagittal plane deformity correction which can be applied for kyphotic deformity correction in thoracolumbar STb cases.

Keywords: cantilever technique; deformity correction; kyphotic deformity; spondylitis tuberculosis; thoracolumbar spine.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
The cantilever method for kyphotic deformity correction: (A) pedicle screw insertion in desired level of stabilization; (B) osteotomy at the apex of deformity; (C) insertion of pre-bend rods; (D) gradual screw tightening from proximal to distal, adjustments are made to achieve final correction. (E) Final construct.
Figure 2
Figure 2
Post-operative results of the kyphotic reduction. (A) Flexible deformity; (B) fixed deformity (black arrow: fused anterior segment).
See this image and copyright information in PMC

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References

    1. Jain AK. Tuberculosis of the spine: a fresh look at an old disease. J Bone Jt Surg. 2010;92-B(7):905–913. doi:10.1302/0301-620X.92B7.24668 - DOI - PubMed
    1. Librianto D, Suwarto S, Imran D, et al. An extremely rare case of upper thoracic Salmonella infection. Orthop Res Rev. 2021;13:107–112. doi:10.2147/ORR.S319616 - DOI - PMC - PubMed
    1. Jain A, Dhammi I, Jain S, Mishra P. Kyphosis in spinal tuberculosis - prevention and correction. Indian J Orthop. 2010;44(2):127. doi:10.4103/0019-5413.61893 - DOI - PMC - PubMed
    1. Issack PS, Boachie-Adjei O. Surgical correction of kyphotic deformity in spinal tuberculosis. Int Orthop. 2012;36(2):353–357. doi:10.1007/s00264-011-1292-9 - DOI - PMC - PubMed
    1. Librianto D, Aprilya D. Cantilever method for severe kyphotic deformity correction in spondylitis tuberculosis: a technical note and literature review. Ann Med Surg. 2021;69:102764. doi:10.1016/j.amsu.2021.102764 - DOI - PMC - PubMed

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