110 likes | 607 Views
INTERRADICULAR BONE-DISC-BONE OSTEOTOMY (BDBO): AN ALTERNATIVE TO OTHER OSTEOTOMY TYPES FOR THE CORRECTION OF THORACOLUMBAR AND LUMBAR SPINE DEFORMITIES. Cagatay OZTURK, MD Mehmet AYDOGAN, MD Selhan KARADERELER, MD Mehmet TEZER, MD Ahmet ALANAY, MD Azmi HAMZAOGLU, MD Istanbul Spine Center
E N D
INTERRADICULAR BONE-DISC-BONE OSTEOTOMY (BDBO): AN ALTERNATIVE TO OTHER OSTEOTOMY TYPES FOR THE CORRECTION OF THORACOLUMBAR AND LUMBAR SPINE DEFORMITIES Cagatay OZTURK, MD Mehmet AYDOGAN, MD Selhan KARADERELER, MD Mehmet TEZER, MD Ahmet ALANAY, MD Azmi HAMZAOGLU, MD Istanbul Spine Center Florence Nightingale Hospital Istanbul-TURKEY
PURPOSE • To introduce and evaluate the results of interradicular bone disc bone osteotomy. • 12 consecutive patients with thoracolumbar and lumbar deformities managed by BDBO and having more than 2 years of follow-up were evaluated. PATIENT SAMPLE
METHODS • Inthesurgery; • pediclescrews at least 3 levelsbelowand 2 levelsabovetheplannedosteotomylevel. • Widelaminectomies at thevertebraeaboveandbelowthediscspaceplannedto be resected. • Then, a wedgeosteotomyjustbelowthepedicle of theupperadjacentvertebraand a straightosteomythroughtheupperendplate of theloweradjacentvertebra, includingthedisctissue . • An anterior mesh cageplacediflengthening of theanteriorcolumn is desired. • Then, theosteotomyside is closed
RESULTS • Averageage of patients (6M, 6F) 51 (7-76) y • Averagefollow-up 47 (24-89) months. • Deformitiesincluded; • kyphosis in 7 patients • kyphoscoliosis in 5 patients.
RESULTS • Preoperative kyphosis of 24 degrees was corrected to -15 degrees of lordosis with an average of 38 degrees of correction. • Preoperative scoliosis of 21 degrees was corrected to 8 degrees and found to be 10 degrees at the final follow-up. • Averagenumber of instrumentedvertebraewas 10. • Majorcomplicationsincluded dural tear in 4 patients. • Therewas no neurologicalinjury.
Bone-Disc-Bone Resection 30°-35° 40° 60°
MIA, 59y, F, lumbar kyphoscoliosis, B-D-B resection 44° L2 L2 L3 L2 L3 L3 38°
CONCLUSION • BDBO is an effective surgery providing an average of 39 degrees of correction in sagittal plane and may be an alternative to PVCR for patients with thoracolumbar and lumbar severe and rigid deformities, particularly if the apex of deformity is a disc level.