Treatment of rigid post‑traumatic thoracolumbar kyphosis by a novel technique of spinal joints release

Journal of Orthopaedic Surgery and Research, 2023 · DOI: https://doi.org/10.1186/s13018-023-03599-7 · Published: March 1, 2023

Surgery Orthopedics

Simple Explanation

This study introduces a new surgical technique, spinal joints release (SJR), for treating rigid post-traumatic thoracolumbar kyphosis (RPTK). The technique aims to correct spinal deformities while minimizing trauma and blood loss compared to traditional methods. SJR involves facet resection, limited laminotomy, clearance of the intervertebral space, and release of the anterior longitudinal ligament. This approach seeks to restore vertebral height, avoid spinal cord shortening, and decompress the spinal cord. The study followed 43 patients who underwent SJR and found significant improvements in pain, disability, and kyphosis correction. The results suggest that SJR is a feasible and effective option for RPTK, offering advantages over more invasive surgical techniques.

Study Duration

August 2015 to August 2021

Participants

43 patients with rigid post-traumatic thoracolumbar kyphosis

Evidence Level

Not specified

Key Findings

1
The study achieved an 87% correction rate of kyphosis, with the Cobb angle decreasing from 27.7° preoperatively to 5.4° at the final follow-up.
2
VAS scores and ODI index significantly improved at the final follow-up, indicating reduced pain and improved functional ability.
3
All seventeen patients with incomplete spinal cord injury achieved more than one grade of neurological recovery at the final follow-up.

Research Summary

This study evaluated the feasibility and efficacy of a novel surgical technique, spinal joints release (SJR), for treating rigid post-traumatic thoracolumbar kyphosis (RPTK). The method involves a posterior approach with facet resection, limited laminotomy, intervertebral space clearance, and anterior longitudinal ligament release. Forty-three patients were treated with SJR, and the results demonstrated significant improvements in kyphosis correction, pain reduction, and functional outcomes. The technique also showed a favorable safety profile with fewer complications compared to traditional osteotomy methods. The authors conclude that posterior SJR surgery for RPTK offers the advantages of less trauma and blood loss, with satisfactory kyphosis correction, making it a viable option for patients with this condition.

Practical Implications

Less Invasive Surgical Option

SJR offers a less invasive alternative to traditional osteotomy techniques for treating RPTK, potentially reducing surgical trauma and blood loss.

Improved Patient Outcomes

The study suggests that SJR can lead to significant improvements in kyphosis correction, pain reduction, and functional ability for patients with RPTK.

Neurological Recovery

The findings indicate that SJR may contribute to neurological recovery in patients with incomplete spinal cord injury associated with RPTK.

Study Limitations

1
The study lacks a control group for comparison.
2
The follow-up period averaged 26 months, which may not be sufficient to assess long-term outcomes.
3
The study did not specify if a power analysis was performed to determine sample size.

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