Modified Bone-Disc-Bone Osteotomy for Spinal Kyphosis: A Retrospective Clinical Study with 2-Year Follow-Up

Abstract

To determine the efficacy of modified bone-disc-bone osteotomy to treat spinal kyphosis. Between January 2018 and December 2022, 20 patients underwent modified bone-disc-bone osteotomy surgery for spinal kyphosis. Radiologic parameters pelvic incidence, pelvic tilt, sagittal vertical axis, and kyphotic Cobb angle were measured and compared. Oswestry Disability Index, visual analog scale, and general complications were recorded to evaluate clinical outcomes. All 20 patients completed 24 months of postoperative follow-up. Mean kyphotic Cobb angle correction was from 40.2 ± 6.8° to 8.9 ± 4.1° immediately after surgery to 9.8 ± 4.8° at 24 months postoperatively. Average surgical time was 277 minutes (range, 180-490 minutes). Mean intraoperative blood loss was 1215 mL (range, 800-2500 mL). Sagittal vertical axis was improved from 4.2 cm (range, 1-5.8 cm) preoperatively to 1.1 cm (range, 0-2 cm) at final follow-up (P < 0.05). Pelvic tilt was reduced from 27.6 ± 4.1 preoperatively to 14.9 ± 4.4 postoperatively (P < 0.05). Visual analog scale decreased from 5.8 ± 1.1 preoperatively to 1 ± 0.6 at final follow-up (P < 0.05). Oswestry Disability Index changed from 28.7 ± 2.7% preoperatively to 9.4 ± 1.8% at final follow-up. Bony fusion was achieved at 12 months postoperatively in all patients. All patients experienced significant improvement in clinical symptoms and neurological function at final follow-up. Modified bone-disc-bone osteotomy surgery is an effective and safe method for treatment of spinal kyphosis.