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KMID : 1145220230200030989
Neurospine
2023 Volume.20 No. 3 p.989 ~ p.996
Long-term Outcomes of Posterior Multilevel Crack Osteotomy: Revisional Surgery for Scoliosis With a Fusion Mass
Song Mi-Hyun

Yang Jae-Hyuk
Chang Dong-Gune
Thi-Kem Nguyen
Suh Seung-Woo
Abstract
Objective : Osteotomies are required for the mobilization of spinal segments in patients with revisional scoliosis surgery with a fusion mass; however, only a few techniques have shown efficacy and safety, and their mid- and long-term outcomes remain unelucidated. This study aimed to analyze long-term outcomes of the posterior multilevel crack osteotomy (PMCO) technique for revisional surgery for scoliosis with a fusion mass.

Methods : Data from 18 patients who underwent revisional scoliosis surgery using PMCO between 2009 and 2015 and had more than 5-year follow-up were retrospectively reviewed. The Cobb angle and coronal and sagittal balance parameters were examined preoperatively, postoperatively, and during the final follow-up. Perioperative parameters and complications were also assessed.

Results : Preoperative and postoperative Cobb angles were 60.5¡Æ and 29.9¡Æ, respectively (p < 0.001); this improvement was maintained until the final follow-up (33.4¡Æ, p = 0.058). The difference in preoperative and postoperative coronal balance was statistically significant (15.9 mm and 9.2 mm, respectively; p < 0.001); this was maintained until the final follow-up (p = 0.071). There was no change in sagittal balance parameters over the 3 measurement periods. Only 1 patient showed PMCO-related motor weakness, but he spontaneously recovered 3 months after postsurgery. Pseudarthrosis was not observed during the follow-up period.

Conclusion : Incomplete osteotomy using PMCO provided satisfactory deformity correction without severe complications during revisional surgery for scoliosis with a fusion mass. It may be a less invasive procedure that maintains cortical continuity, preserves soft tissues, and provides sufficient mobility for the correction of spinal segments.
KEYWORD
Scoliosis, Revisional surgery, Multilevel osteotomy, Incomplete osteotomy, Deformity correction
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