Three-column osteotomies of the lower cervical and upper thoracic spine: comparison of early outcomes, radiographic parameters, and peri-operative complications in 48 patients

Alexander A. Theologis, Ehsan Tabaraee, Haruki Funao, Justin S. Smith, Shane Burch, Bobby Tay, Khaled M Kebaish, Vedat Deviren, Christopher Ames

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate and compare early radiographic and clinical outcomes of lower cervical and upper thoracic three-column osteotomies (3CO) for cervicothoracic kyphosis correction.

Methods: Patients who underwent 3CO at the cervicothoracic junction at two institutions were retrospectively reviewed. Patients were divided into two groups: lower cervical osteotomy (LCO) and upper thoracic osteotomy (UTO: T1–T5). Operative data, radiographic alignment, peri-operative complications, and clinical outcomes were compared between the groups.

Results: Forty-eight patients [male: 24; female: 24; average age 61 years (range 18–92 years); mean follow-up: 22 months] met inclusion criteria. A total of 24 pedicle subtraction osteotomies and 24 vertebral column resections were performed. Compared to UTO, LCO operative time was significantly shorter, average ICU and hospital stays were significantly longer, and the average pre-operative cervical sagittal vertical axis (SVA) and kyphosis were significantly greater (p 

Conclusions: Three-column posterior osteotomies at the cervicothoracic junction restored regional sagittal alignment and improved quality of life in this series of patients with rigid cervicothoracic deformity, albeit with high complication rates. Lower cervical osteotomies provided greater cervical SVA correction and were shorter operations, although they were associated with more complications and longer hospital and ICU stays compared to upper thoracic osteotomies.

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalEuropean Spine Journal
Volume24
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Osteotomy
Spine
Thorax
Kyphosis
Length of Stay
Operative Time
Quality of Life

Keywords

  • Cervicothoracic
  • Chin-on-chest
  • Clinical outcomes
  • Kyphosis
  • Pedicle subtraction osteotomy
  • Vertebral column resection

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Three-column osteotomies of the lower cervical and upper thoracic spine : comparison of early outcomes, radiographic parameters, and peri-operative complications in 48 patients. / Theologis, Alexander A.; Tabaraee, Ehsan; Funao, Haruki; Smith, Justin S.; Burch, Shane; Tay, Bobby; Kebaish, Khaled M; Deviren, Vedat; Ames, Christopher.

In: European Spine Journal, Vol. 24, No. 1, 2014, p. 23-30.

Research output: Contribution to journalArticle

Theologis, Alexander A. ; Tabaraee, Ehsan ; Funao, Haruki ; Smith, Justin S. ; Burch, Shane ; Tay, Bobby ; Kebaish, Khaled M ; Deviren, Vedat ; Ames, Christopher. / Three-column osteotomies of the lower cervical and upper thoracic spine : comparison of early outcomes, radiographic parameters, and peri-operative complications in 48 patients. In: European Spine Journal. 2014 ; Vol. 24, No. 1. pp. 23-30.
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AB - Purpose: To evaluate and compare early radiographic and clinical outcomes of lower cervical and upper thoracic three-column osteotomies (3CO) for cervicothoracic kyphosis correction.Methods: Patients who underwent 3CO at the cervicothoracic junction at two institutions were retrospectively reviewed. Patients were divided into two groups: lower cervical osteotomy (LCO) and upper thoracic osteotomy (UTO: T1–T5). Operative data, radiographic alignment, peri-operative complications, and clinical outcomes were compared between the groups.Results: Forty-eight patients [male: 24; female: 24; average age 61 years (range 18–92 years); mean follow-up: 22 months] met inclusion criteria. A total of 24 pedicle subtraction osteotomies and 24 vertebral column resections were performed. Compared to UTO, LCO operative time was significantly shorter, average ICU and hospital stays were significantly longer, and the average pre-operative cervical sagittal vertical axis (SVA) and kyphosis were significantly greater (p Conclusions: Three-column posterior osteotomies at the cervicothoracic junction restored regional sagittal alignment and improved quality of life in this series of patients with rigid cervicothoracic deformity, albeit with high complication rates. Lower cervical osteotomies provided greater cervical SVA correction and were shorter operations, although they were associated with more complications and longer hospital and ICU stays compared to upper thoracic osteotomies.

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