title: Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis: experience with 78 patients.
abstract: METHODS
  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.
  
  
  BACKGROUND
  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.
authors.affiliation: Department of Orthopedics, Tzu-Chi Medical Center, Hua-lien, Taiwan. db0077@tzuchi.com.tw
authors.forename: I H
authors.initials: IH
authors.lastname: Chen
authors.forename: J T
authors.initials: JT
authors.lastname: Chien
authors.forename: T C
authors.initials: TC
authors.lastname: Yu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome