Study Design. A retrospective case study was performed on the single-s
tage posterior transvertebral closing-wedge osteotomy for treatment of
adult thoracolumbar kyphosis. Summary of Background Data. Forty-one c
onsecutive cases in 38 patients available for follow-up, averaging 33
months (range 4-87 months), are included. All patients had severe pain
and/or deformity; 51% of cases had previous fractures, and 49% had po
stlaminectomy failed back syndromes with kyphosis. A preoperative neur
ologic deficit was present in 34% of the cases including two with caud
a equina syndrome. Methods. Patient examination and interviews, subjec
tive questionnaire, chart reviews, and radiographic measurements were
performed independently. Complications, risks, benefits, results, and
biomechanical considerations were evaluated and discussed as compared
with other techniques. Results. All cases had solid-union at follow-up
; 93% maintained correction averaging 35-degrees with three requiring
revision for failure. Postoperatively, 19.5% of the cases had new neur
ologic deficits with five (12.2%) temporary or minor and three (7.3%)
major, including one with unimproved paraplegia at follow-up. Eight of
the 14 preoperative neurologic deficit cases improved postoperatively
; 26 additional surgeries were performed on 18 patients most commonly
for pain (x 11) and additional trauma (x4). The subjective questionnai
re results indicated significant patient satisfaction, with 76% statin
g they would repeat the surgery and 90% recommending it to another. Co
nclusion. This technically demanding high-risk procedure provides an e
ffective and mechanically superior correction for acute angle thoracol
umbar kyphosis in selected adult patients, with high subjective satisf
action.