Kyphosis is a common sequel of inadequately
managed thoracolumbar fractures. This study compares
between pedicle subtraction osteotomy (PSO) and anterior
corpectomy and plating (ACP) for correcting post-traumatic
kyphosis. Forty-three patients with symptomatic
post-traumatic kyphosis of the thoracolumbar spine were
treated with PSO and prospectively followed for a minimum
of 2 years. Visual Analogue Scale (VAS) and Oswestry
Disability Index (ODI) were used to assess clinical
improvement and radiographs were obtained at 2, 6, 12 and
24 months. The recorded clinical and radiological outcomes
were compared to a control group of 37 patients,
who were treated earlier by the same authors with ACP.
The mean correction of the kyphotic angle was 29.8 for
the PSO group and 22 for the ACP group (P = 0.001).
PSO group showed significantly better improvement in the
VAS score and the ODI. At final follow-up, patients
reported very good satisfaction (93% in PSO vs. 81% in
ACP) and good function (90% in PSO vs. 73% in ACP).
Complications in the PSO group included pulling out of
screws and recurrence of deformity requiring revision and
longer fixation (1 patient), and transient lower limb paraesthesia
(2 patients). Recorded complications in the ACP
group included an aortic injury (1 patient) that was successfully
repaired, pseudarthrosis (1 patient), persistent
graft donor site morbidity (3 patients), and incisional hernia
(1 patient). PSO and ACP are demanding procedures. PSO
seems to be equally safe but more effective than ACP for
correcting post-traumatic kyphosis.