Skip to main content

Basic Surgical Technique for Management of AS Kyphosis

  • Chapter
  • First Online:
Surgical Treatment of Ankylosing Spondylitis Deformity

Abstract

Ankylosing spondylitis (AS) results in typical spinal deformities, for example, flattening of lumbar lordosis or lumbar kyphosis, as well as worsening of smooth thoracic hyperkyphosis. These fixed kyphosis and synthetic positive sagittal deformities not only damage the walking ability but also lead to significant pain, which may limit many patients’ mental activity and physiological functions, such as interpersonal communication, walking, driving, and the like. Surgery may be the appropriate option for managing these patients [1]. Of course, dysfunction’s degree is a vital factor when considering surgery [2], because most patients require spinal osteotomy to obtain adequate correction, so patients are a huge challenge for spine surgeons during surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bridwell KH. Decision making regarding Smith-Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine. 2006;31:S171–8.

    Article  PubMed  Google Scholar 

  2. Simmons EH. Kyphotic deformity of the spine in ankylosing spondylitis. Clin Orthop. 1977;128:65–77.

    Google Scholar 

  3. Gerscovich EO, Greenspan A, Montesano PX. Treatment of kyphotic deformity in ankylosing spondylitis. Orthopedics. 1994;17:335–42.

    CAS  PubMed  Google Scholar 

  4. McMaster MJ. A technique for lumbar spinal osteotomy in ankylosing spondylitis. J Bone Joint Surg Br. 1985;67:204–10.

    Article  CAS  PubMed  Google Scholar 

  5. Hehne HJ, Zielke K, Bohm H. Polysegmental lumbar osteotomies and transpedicled fixation for correction of long-curved kyphotic deformity in ankylosing spondylitis: report on 177 cases. Clin Orthop. 1990;258:49–55.

    Google Scholar 

  6. Bridwell K, Lewis S, Rinella A, et al. Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. Surgical technique. J Bone Joint Surg Am. 2004;86:44–9.

    Article  PubMed  Google Scholar 

  7. Thiranont N, Netrawichien P. Transpedicular decancellation closed wedge vertebral osteotomy for treatment of fixed flexion deformity of spine in ankylosing spondylitis. Spine. 1993;18:2517–22.

    Article  CAS  PubMed  Google Scholar 

  8. Smith-Petersen MN, Larson CB, Aufranc OE, et al. Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis. J Bone Joint Surg Am. 1945;27:1–11.

    Google Scholar 

  9. Chen IH, Chien JT, Yu TC. Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis: experience with 78 patients. Spine (Phila Pa 1976). 2001;26:E354–60.

    Article  CAS  Google Scholar 

  10. Styblo K, Bossers GT, Slot GH. Osteotomy for kyphosis in ankylosing spondylitis. Acta Orthop Scand. 1985;4:294–7.

    Article  Google Scholar 

  11. Zheng G-Q, Song K, Zhang Y-G, Wang Y, Huang P, Zhang X-S, et al. Two-level spinal osteotomy for severe thoracolumbar kyphosis in ankylosing spondylitis; Wang Y, Lenke LG. Vertebral column decancellation for the management of sharp angular spinal deformity. Eur Spine J. 2011;20:1703–10.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Liu H, Yang C, Zheng Z, Ding W, Wang J, Wang H, et al. Comparison of Smith-Petersen osteotomy and pedicle subtraction osteotomy for the correction of thoracolumbar kyphotic deformity in ankylosing spondylitis. Spine. 2015;40:570–9.

    Article  PubMed  Google Scholar 

  13. Kawaharu H, Tomita K. Influence of acute shortening on the spinal cord: an experimental study. Spine. 2005;30:613–20.

    Article  Google Scholar 

  14. Lehmer SM, Keppler L, Buscup RS, et al. Posterior transvertebral osteotomy for adult thoracolumbar kyphosis. Spine. 1994;19:2060–7.

    Article  CAS  PubMed  Google Scholar 

  15. Gertzbein SD, Harris MB. Wedge osteotomy for the correction of posttraumatic kyphosis. Spine. 1992;17:374–9.

    Article  CAS  PubMed  Google Scholar 

  16. von Royen BJ, Slot GM. Closing-wedge posterior osteotomy for ankylosing spondylitis. J Bone Joint Surg Br. 1995;77:117–21.

    Article  PubMed  Google Scholar 

  17. Boachie-Adjei O, Ferguson JI, Pigeon RG, et al. Transpedicular lumbar wedge resection osteotomy for fixed sagittal imbalance: surgical technique and farly results. Spine. 2006;31:485–92.

    Article  PubMed  Google Scholar 

  18. Wang Y, Zhang Y, Zhang X, et al. A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases. Eur Spine J. 2008;17(3):361–72.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Wang Y, Lenke LG. Vertebral column decancellation for the management of sharp angular spinal deformity. Eur Spine J. 2011;20(10):1703–10.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Zheng, G., Xin, Z., Wang, Y. (2019). Basic Surgical Technique for Management of AS Kyphosis. In: Wang, Y. (eds) Surgical Treatment of Ankylosing Spondylitis Deformity . Springer, Singapore. https://doi.org/10.1007/978-981-13-6427-3_7

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-6427-3_7

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-6426-6

  • Online ISBN: 978-981-13-6427-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics