A transpedicular wedge opening osteotomy can be considered as part of the surgical treatment of symptomatic sagittal imbalance. The literature is limited to the prescription this technique by El meshtawy and no more.
Purpose: To evaluate our preliminary results of transpedicular wedge opening osteotomy as surgical treatment of chronic symptomatic post- traumatic kyphosis. Study Design: Case series.
Methods: seventeen patients with symptomatic kyphotic deformity were treated with a transpedicular wedge opening osteotomy. The mean follow-up was 42.8 months (range 26–105). The clinical outcome, radiographic correction, and perioperative complications were analyzed.
Results: All patients were successfully managed with this procedure without major complications. All patients were instrumented with posterior-only fixation with two levels above and two levels below. The mean blood loss was 338.24 ± 99.26 mL (range, 150.0 – 500.0mL). Patients were followed for an average of 32 months (range, 6–70 mo.) postoperatively. Back pain was significantly improved to 1.41 ± 0.80 at the latest follow up and the Oswestry disability index (ODI) was also significantly improved to mean 8.12 ± 2.60. Average kyphotic angle was -0.59 ° ± 3.99° immediately after surgery and 0.57 ° ± 2.82 ° at final follow-up. Average of 1 ° of correction loss was documented and all patients obtained healing of the osteotomy site.
Conclusions: A transpedicular wedge opening osteotomy is a technically demanding but well tolerated operative procedure for the correction of post traumatic kyphosis. This technique results in satisfactory clinical results not only in the form of pain relief, kyphosis correction, but also in the form of reducing the risk of excessive bleeding and spinal cord injury with motion preservation of the spinal column.