CLOSING-WEDGE POSTERIOR OSTEOTOMY FOR ANKYLOSING-SPONDYLITIS - PARTIAL CORPORECTOMY AND TRANSPEDICULAR FIXATION IN 22 CASES

From 1990 to 1993 we treated 22 consecutive patients who had progressi ve spinal kyphosis due to ankylosing spondylitis by a closing-wedge po sterior vertebral osteotomy with partial corporectomy of L4 and transp edicular fixation. The average correction was 32 degrees (24 to 52) wi th a mean loss of correction after operation of 2.7 degrees (0 to 13), The average operating time was 185 minutes (135 to 240) and blood los s was 2500 ml (1200 to 5000). The osteotomy corrected all patients suf ficiently to allow them to see ahead and their posture was improved. T here were no fatal complications, but in two cases there was failure o f the instrumentation and one patient needed reoperation for nerve com pression. Two deep wound infections required removal of the implant an d six patients had superficial skin infections under the plaster. The use of a circoelectric bed and intermittent prone lying eliminated thi s problem.