Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis: experience with 78 patients

Spine (Phila Pa 1976). 2001 Aug 15;26(16):E354-60. doi: 10.1097/00007632-200108150-00010.


Study design: This is a retrospective study of surgical correction of thoracolumbar kyphosis caused by ankylosing spondylitis.

Objective: To report the surgical results of thoracolumbar kyphosis deformity corrected with transpedicular wedge osteotomy performed by a single surgeon at a university hospital.

Summary of background data: There has not been a large series in the literature reporting on results of the Thomasen-type closing wedge osteotomy for correction of kyphosis deformity secondary to ankylosing spondylitis, nor has two-level osteotomy of this type in one patient ever been described.

Methods: From 1991 through 1998, 92 transpedicular wedge osteotomies were performed in 78 patients with ankylosing spondylitis for correction of fixed flexion deformity of the thoracolumbar spine.

Results: The mean amount of correction for each level of osteotomy was 34.5 degrees (range, 15 degrees -60 degrees ). The largest amount of overall correction for a single patient was 100 degrees. Most of the osteotomies (64 of 92) were done at L2 and L3. Fourteen patients with severe deformity required staged two-level osteotomy. Excellent and good results were obtained in 77 patients (98.7%) at the final follow-up. There was no mortality, nor were there any major neurological complications.

Conclusions: Transpedicular wedge osteotomy can effectively and safely correct kyphotic deformity of the thoracolumbar spine caused by ankylosing spondylitis, regardless of rigidity of the spinal curves. Two-level osteotomy can provide sufficient correction for severe cases.

MeSH terms

  • Adult
  • Female
  • Humans
  • Kyphosis / etiology
  • Kyphosis / pathology
  • Kyphosis / surgery*
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Osteotomy / instrumentation
  • Osteotomy / methods*
  • Retrospective Studies
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / pathology
  • Spondylitis, Ankylosing / surgery*
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery*
  • Treatment Outcome