PT  - JOURNAL ARTICLE
AU  - ZÁRATE-KALFÓPULOS, BARÓN
AU  - NAVARRO-ACEVES, LUIS ALBERTO
AU  - REYNOSO-CANTÚ, HUGO
AU  - REYES-SÁNCHEZ, ALEJANDRO
AU  - GARCÍA-RAMOS, CARLA LISSETTE
AU  - REYES-TARRAGÓ, FERNANDO
AU  - ALPÍZAR-AGUIRRE, ARMANDO
TI  - Posterior Grade 4 Osteotomy With Vertebral Shortening Is Effective for the Treatment of Kyphosis Associated With Vertebral Discitis/Osteomyelitis
AID  - 10.14444/7040
DP  - 2020 Jun 01
TA  - International Journal of Spine Surgery
PG  - 300--307
VI  - 14
IP  - 3
4099  - https://www.ijssurgery.com/content/14/3/300.short
4100  - https://www.ijssurgery.com/content/14/3/300.full
SO  - Int J Spine Surg2020 Jun 01; 14
AB  - Background: In the retrospective study of a prospectively maintained database, we present a case series of patients with kyphotic deformity secondary to spinal infection treated using a posterior-only approach with 3-column shortening and posterior instrumentation.Methods: This is a case series of patients presenting with postural deformity and sagittal imbalance treated consecutively by 1 surgeon between 2012 and 2014. Clinical assessments and radiographic evaluations were made preoperatively and at 12- and 24-month postoperative follow-ups. All patients underwent computed tomography 24 months after surgery to evaluate spinal fusion.Results: The study included 5 patients with a mean age of 50 years (range, 32–60 years). Three patients had comorbidities. Three patients were classified as American Spinal Injury Association (ASIA) grade C and were not ambulatory; 2 were ASIA grade D. At follow-up, all patients were ambulatory and classified as ASIA grade E. Kyphosis was corrected from a preoperative mean of 32° (range, 15°–58°) to 10° (range, 1°–42°) at the 2-year follow-up. A mean improvement of 22° and 75% reduction in kyphosis was obtained with fixation 2 levels above and below the lesion. Interbody fusion was observed in all patients. No major complications occurred during surgery.Conclusions: Posterior grade 4 osteotomy with vertebral shortening can be performed safely in patients with kyphosis associated with vertebral discitis/osteomyelitis in the thoracolumbar region. The single approach allowed the surgeon to debride the infection, correct the kyphosis, decompress the spinal canal, and stabilize the spine.Level of Evidence: 4.