533 - The Use of Simultaneous Multilevel Pedicle Subtraction Osteotomies to...

#533 The Use of Simultaneous Multilevel Pedicle Subtraction Osteotomies to Correct Severe Kyphoses in Ankylosing Spondilitis

Sagittal Balance

Poster Presented by: M.E. Inanmaz


M.E. Inanmaz (1)
K.C. Kose (1)
C. Isik (2)
H. Basar (1)
I. Caliskan (1)

(1) Sakarya University, Adapazari, Turkey
(2) Bolu Izzet Baysal University, Bolu, Turkey


Introduction: Various osteotomies have been devised to treat the kyphosis in ankylosingspondilitis patients, most widely used being the pedicle subtraction osteotomy (PSO). One level PSO is frequently used but to our knowledge simultaneous multilevel osteotomies have never been reported.

Method: Ten patients have undergone multilevel PSO in one stage between 2010-2012. 4 patients had 2 level and 2 had 3 level osteotomies. The mean preoperative global spinal kyphosis angles were 107.4 (range 80-135) The mean sagittal imbalance was 24 cm forward. The thoracic osteotomies were done at T7-T8-T11 levels. The lumbar osteotomies were done at L2.

Results: The average age was 46.8 years (range 37-53 years). The duration of follow-up was 15,3 months. The mean duration of operation was 270 minutes. The mean amount of blood loss was 1460 cc. Significant correction of deformities could be achieved. The sagittal balance was corrected to 2,8 cm.The mean kyphosis angle decreased to 44,6. No patient had neurologic deficits, pseudoarthrosis, deep infection or implant failure. One had aseptic wound drainage due to allografts.

Conclusion: Simultaneous multilevel osteotomies can correct the rigid kyphosis in the severely deforme ankylosed spine and can be performed in a safe manner.