Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment
Abstract Purpose To investigate the influence of apical vertebrae difference (AVD) on surgical decision-making and clinical outcomes of single- and two-level osteotomy in ankylosing spondylitis (AS) thoracolumbar kyphoscoliosis with sagittal and coronal imbalance. Methods A total of 27 AS patients w...
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BMC
2025-08-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-06090-7 |
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| author | Jie Cheng Tao Xu Maierdan Maimaiti Rui Cao Chuanhui Xun Weidong Liang Weibin Sheng |
| author_facet | Jie Cheng Tao Xu Maierdan Maimaiti Rui Cao Chuanhui Xun Weidong Liang Weibin Sheng |
| author_sort | Jie Cheng |
| collection | DOAJ |
| description | Abstract Purpose To investigate the influence of apical vertebrae difference (AVD) on surgical decision-making and clinical outcomes of single- and two-level osteotomy in ankylosing spondylitis (AS) thoracolumbar kyphoscoliosis with sagittal and coronal imbalance. Methods A total of 27 AS patients with thoracolumbar kyphoscoliosis were enrolled in the study. Patients were divided into single- and two-level osteotomy groups based on the number of osteotomy levels. Coronal, sagittal, and clinical parameters were measured preoperatively, postoperatively, and at the last follow-up. AVD, operation time, blood loss, fused segments and complications were recorded between the two groups. Results Among 27 patients, 11 underwent single-level osteotomy and 16 underwent two-level osteotomy. The operation time, blood loss and number of fused segments were lower in single-level group compared to the two-level group (P < 0.001). Coronal, sagittal, and clinical parameters improved significantly after surgery (P < 0.05), with only osteotomized vertebral angle (OVA) showing a significant difference between the two groups (P < 0.05). The average AVD was 1.50 segments in single-level group and 3.30 segments in two-level group. Additionally, single- and two-level osteotomy accounted for 80% and 20% in group A, 77.8% and 22.2% in group B, and 0% and 100% in group C, respectively. Conclusion AVD was a crucial parameter in determining whether single- or two-level osteotomy was appropriate for AS patients with thoracolumbar kyphoscoliosis. If the AVD was < 3 segments, single-level osteotomy should be considered. If the AVD was ≥ 3 segments, two-level osteotomy was recommended. |
| format | Article |
| id | doaj-art-e0b3d87bbb734af39e93238ccd23df06 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-e0b3d87bbb734af39e93238ccd23df062025-08-24T11:40:36ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-08-0120111210.1186/s13018-025-06090-7Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignmentJie Cheng0Tao Xu1Maierdan Maimaiti2Rui Cao3Chuanhui Xun4Weidong Liang5Weibin Sheng6Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical UniversityAbstract Purpose To investigate the influence of apical vertebrae difference (AVD) on surgical decision-making and clinical outcomes of single- and two-level osteotomy in ankylosing spondylitis (AS) thoracolumbar kyphoscoliosis with sagittal and coronal imbalance. Methods A total of 27 AS patients with thoracolumbar kyphoscoliosis were enrolled in the study. Patients were divided into single- and two-level osteotomy groups based on the number of osteotomy levels. Coronal, sagittal, and clinical parameters were measured preoperatively, postoperatively, and at the last follow-up. AVD, operation time, blood loss, fused segments and complications were recorded between the two groups. Results Among 27 patients, 11 underwent single-level osteotomy and 16 underwent two-level osteotomy. The operation time, blood loss and number of fused segments were lower in single-level group compared to the two-level group (P < 0.001). Coronal, sagittal, and clinical parameters improved significantly after surgery (P < 0.05), with only osteotomized vertebral angle (OVA) showing a significant difference between the two groups (P < 0.05). The average AVD was 1.50 segments in single-level group and 3.30 segments in two-level group. Additionally, single- and two-level osteotomy accounted for 80% and 20% in group A, 77.8% and 22.2% in group B, and 0% and 100% in group C, respectively. Conclusion AVD was a crucial parameter in determining whether single- or two-level osteotomy was appropriate for AS patients with thoracolumbar kyphoscoliosis. If the AVD was < 3 segments, single-level osteotomy should be considered. If the AVD was ≥ 3 segments, two-level osteotomy was recommended.https://doi.org/10.1186/s13018-025-06090-7Ankylosing spondylitisBiplanar imbalanceSingle-level osteotomyTwo-level osteotomyApical vertebrae difference |
| spellingShingle | Jie Cheng Tao Xu Maierdan Maimaiti Rui Cao Chuanhui Xun Weidong Liang Weibin Sheng Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment Journal of Orthopaedic Surgery and Research Ankylosing spondylitis Biplanar imbalance Single-level osteotomy Two-level osteotomy Apical vertebrae difference |
| title | Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment |
| title_full | Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment |
| title_fullStr | Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment |
| title_full_unstemmed | Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment |
| title_short | Single- and two-level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment |
| title_sort | single and two level osteotomy for the treatment of thoracolumbar kyphosis in ankylosing spondylitis patients with concomitant coronal malalignment |
| topic | Ankylosing spondylitis Biplanar imbalance Single-level osteotomy Two-level osteotomy Apical vertebrae difference |
| url | https://doi.org/10.1186/s13018-025-06090-7 |
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