Purpose

To report on quality of life and radiological changes of Ponte osteotomies (POs) with long fixation for primary and revision surgery, in elderly women with adult spinal deformity (ASD).

Methods

Sixty-seven (67) women, aged 69 ± 7 years, received 3 POs, spinopelvic fixation plus TLIFs. Forty-nine (73%) patients received primary and 18 (27%) revision surgery. Survivorship analysis was made for unplanned revision surgery for broken rods (BR); proximal junction failure (PJF); and deep wound infection (DWI). ODI and SF-36 were used for disability (ODI) and quality of life (SF-36) evaluation.

Results

In total, 201 lumbar POs were made and 9.55 ± 3 levels fused. All patients were available 49 ± 11 months postoperatively. Postoperatively, SVA, CSVL, PI-LL, scoliosis, PT and T9-spinopelvic inclination were reduced, while LL and SS were increased significantly. At the final visit, PI−LL ≤ 10° was achieved in 26 (39.4%) patients; ≤ 15° in 51 (76%) patients, while all 67 patients showed a PI−LL ≤ 20°. Unplanned reoperation was performed in 11 (16.4%) patients: for BR in 5 (7.5%); for PJF in 3 (4.5%) and for DWI in 3 (4.5%) patients, respectively. With end point the reoperation for any reason the survival ± SE was 67.8% ± 0.1; for PJF 89.6 ± 0.065; and for BR 76% ± 0.1 in the final evaluation. There was no difference in survival between the primary and revision surgery groups (P = 0.568). ODI and SF-36 scores were improved postoperatively.

Conclusions

Three-segment lumbar POs offered and maintained sufficient improvement of lumbar lordosis along with restoration of the sagittal and coronal spinal alignment, improvement of quality of life and disability of female adult and elderly population after primary and revision surgery for ASD.

中文翻译：

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侵入性较小的骨盆固定的三级腰椎Ponte截骨术可改善中度成人脊柱畸形的成年和老年妇女的脊柱平衡，生活质量并减少残疾。

目的

要报告生活质量和成年脊柱畸形（ASD）老年妇女长期固定用于初次手术和翻修手术的Ponte截骨术（POs）的生活质量和放射学变化。

方法

67名（67）妇女，年龄69±7岁，接受了3例POs，脊柱盂固定术以及TLIF。四十九名（73％）患者接受了原发手术，而十八名（27％）接受了翻修手术。对计划外的折断棒修复手术进行生存分析。近端连接失败（PJF）; 和深伤口感染（DWI）。ODI和SF-36用于残疾（ODI）和生活质量（SF-36）评估。

结果

总共制作了201个腰椎PO，融合了9.55±3个水平。术后49±11个月全部患者。术后，SVA，CSVL，PI-LL，脊柱侧弯，PT和T9-脊柱盆腔倾斜度降低，而LL和SS显着增加。最后一次访视时，有26名（39.4％）患者达到PI-LL≤10°；≤15°在51位患者中（76％），而所有67位患者的PI-LL≤20°。11例（16.4％）患者进行了计划外的再次手术：5例中BR（7.5％）；分别有3例（4.5％）的PJF和3例（4.5％）的DWI。进行终点手术，无论出于何种原因，生存率±SE为67.8％±0.1；对于PJF 89.6±0.065; 最终评估结果为BR 76％±0.1。初级手术组与翻修手术组的生存率无差异（P = 0.568）。术后ODI和SF-36评分提高。

结论

三段式腰椎POs可以并保持腰椎前凸的充分改善，以及矢状和冠状脊柱排列的恢复，生活质量的改善以及ASD初次手术和翻修手术后女性成年人和老年人的残疾。