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LOSS OF CORRECTION AFTER VERTEBRECTOMY FOR TREATMENT OF SPINAL DEFORMITIES

PERDA DE CORREÇÃO APÓS VERTEBRECTOMIA NO TRATAMENTO DE DEFORMIDADES DA COLUNA VERTEBRAL

PÉRDIDA DE CORRECCIÓN DESPUÉS DE VERTEBRECTOMÍA EN EL TRATAMIENTO DE DEFORMIDADES DE LA COLUMNA VERTEBRAL

ABSTRACT

Objective:

To evaluate the loss of correction after treatment of spine deformities with the technique of isolated posterior vertebrectomy.

Methods:

Twenty-one patients were followed-up for three years after surgery with panoramic X-rays, CT scans, SF-36 and Oswestry questionnaires. We evaluated the loss of correction, CAGE subsidence and the evolution of the pelvis-T1 angle during follow-up. The correlation among the radiographic changes and functional and quality of life scores was also assessed.

Results:

All patients had some degree of loss of correction and subsidence of CAGE, especially in the first year of follow-up. Such losses exerted negative impact on the function, pain and self-image of the patients. Factors such as the stiffness of the fusion mass and size of implant used appear to have contributed to the occurrence of subsidence, regardless of age and bone mineral density.

Conclusions:

The use of spacers with larger cross-sectional diameter and more rigid rods can reduce the overloading on the anterior column of Denis, reducing the subsidence and loss of correction. Additional stabilization strategies such as the use of orthoses postoperatively can also be useful, and should be evaluated in subsequent studies.

Keywords:
Spinal diseases; Osteotomy; Subsidence

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