Spinopelvic Balance Restoration Using Posterior Vertebral Column Resection in Fixed Lumbosacral Deformity Following Pyogenic Spondylodiscitis

Abstract

Background data: Several articles reported on posterior vertebral column resection (PVCR) for correction of thor-acolumbar deformities that followed tuberculous spondylodiscitis, but fewer focused on fi xed lumbosacral deformity secondary to L5 pathology. Study design: A retrospective cohort study was performed. Purpose: This article aimed to determine the degree of spinopelvic parameters correction after PVCR of the fi fth lumbar vertebra (L5) in lumbosacral deformities secondary to pyogenic spondylodiscitis and de fi ne its relation to patients ’ clinical and functional outcomes. Patients and methods: This retrospective study included 12 patients with kyphotic lumbopelvic spinal deformity secondary to healed pyogenic spondylodiscitis at the lumbosacral junction. The study included seven (58.3%) males and fi ve (41.7%) females with a mean age of 37.5 ± 7.61 years. Patients were treated with PVCR. Plain radiography, computed tomography, and MRI were performed on all patients, and the following parameters were measured using the Surgimap (version: 2.2.13) computer program: lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and focal deformity angle. Bony fusion is assessed using postoperative radiograph and/or computed tomography. Visual analog scale for both leg and back pain and the Oswestry Disability Index were assessed preoperatively and at the last follow-up. Results: The follow-up period lasted for 16 months (12 e 18). The solid union was achieved in all patients in 8.17 ± 1.52 months with no major postoperative complications. The mean kyphotic deformity was signi fi cantly corrected to ¡ 5.69 ± 6.77 (cid:1) ( P < 0.001). LL signi fi cantly increased to 47.89 ± 3.37 (cid:1) ( P < 0.001). PT decreased signi fi cantly to 17.88 ± 4.132 (cid:1) , and SS increased to 41.13 ± 4.01 (cid:1) . The PI-LL mismatch was corrected to 11.1 ± 4.2 (cid:1) in the fi nal follow-up ( P < 0.001). Oswestry Disability Index improved to 22.50 ± 3.20 postoperatively ( P < 0.001). Conclusion: PVCR provides signi fi cant correction of pelvic parameters and clinical functions of patients with fi xed lumbosacral deformities secondary to pyogenic spondylodiscitis (2022ESJ260).