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Role of Pedicle Subtraction Osteotomy in the treatment of Kyphotic Deformity of the Spine.
Abstract
Objective: To determine the functional and radiological outcome of Pedicle Subtraction Osteotomy (PSO) in the treatment of kyphotic deformity of the spine.
Methods: This descriptive study was conducted in Orthopaedic unit Karnali Academy of Health Sciences, Jumla Nepal and Orthopaedic and Spine unit Lahore General Hospital from 23rd March 2017 to 23rd March 2020.All patients with kyphotic deformity and sagittal imbalance fulfilling the inclusion criteria were treated with PSO. Post operative functional and neurological outcome was assessed with Oswestry Disability Index(ODI) Questionnaire and Frankel Grade system while radiological outcome was evaluated by measuring the Kyphotic angle. Patients were graded as per ODI results as having minimal disability (0 to 20% score), moderate (21% to 40%), severe (41% to 60%), crippled (61% to 80%) and bed bound (81% to 100%) disability. Neurological categorization of the patients were done as per Frankel Grade system from A(Complete motor and sensory deficit) to E (Complete motor and sensory recovery).Comparison of pre operative and post operative ODI and Frankel Grade system was done and P value was calculated with paired Sample-t test and Chi-square test and. P value <0.05 was considered significant.
Results: We operated 15 patients with PSO. The mean age of our patients was 21.6±8.5 years. Female patients were 9(60%) and males were 6(40%). The mean pre-operative ODI of 44.6% (Sever disability) was statistically improved (P<0.05) to 18.66% (Minimal disability) post operatively at one year follow up. The mean pre-operative and post-operative kyphotic angles were 34.72°±4.34° and 1.88°±21.13° (P<0.05) respectively. Neurological deficit improved from Frankel Grade D to E in 1(6.66%) patient while 1(6.66%) patient had post-operative neurological deficit with Frankel grade C at one year follow up.
Conclusion: Pedicle subtraction osteotomy is a safe and valid surgical technique for the correction of kyphotic deformity of the spine as shown by excellent functional and radiological outcome achieved in majority of our patients.
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