Y Shape Osteotomy in Ankylosing Spondylitis, a Prospective Case Series with Minimum 2 Year Follow-Up

<div><p>The aim of the study is to evaluate the efficacy of a spinal osteotomy technique, Y shape osteotomy, for correcting kyphosis in AS patients planned preoperatively with computer software-assistance. 36 consecutive AS patients with thoracolumbar kyphosis were treated with one-stage posterior Y shape osteotomy and preoperative surgical planning was done with the aid of the Surgimap Spine. Radiological parameters of simulation and immediate postoperation were documented. Clinical and radiological results were evaluated in the preoperative, the early postoperative periods and during the last follow-up. The lumbar lordosis was found as 40.7 ± 4.1 degrees in the surgical planning and 49.7 ± 3.9 degrees postoperatively (p<0.01). PI-LL was 3.8± 0.9°in the simulation procedure and 6.6± 1.5°postoperatively (p<0.01). At the final follow-up, Global sagittal balance was restored and Both Oswestry Disability Index and Scoliosis Research Society scores improved largely. In conclusion, Y shape osteotomy is a safe and effective treatment option for AS patients with kyphosis deformity.</p></div

The preoperative and last follow-up data of patients with AS.

<p>The preoperative and last follow-up data of patients with AS.</p

The patient is placed prone on a radiolucent operating table

<p>The patient is placed prone on a radiolucent operating table</p

Pre- and post-operative radiological outcomes.

<p>(A, B, C) AP and lateral standing radiographs and sagittal CT scan of a 36-year-old man with thoracolumbar kyphosis secondary to ankylosing spondylitis; (D, E, F): Y shape osteotomy was performed at L2, and Two years of follow-up revealed the normal sagittal alignment was achieved.</p

The simulation of Y shape osteotomy in surgimap for patients with AS.

<p>(A) Spino- pelvic parameters were measured and analyzed; (B) “Wedge Osteotomy” was applied at the posterior column of L2; (C) radiographic image after simulated osteotomy.</p

Y shape osteotomy.

<p>(A) ‘Y’ type osteotomy was achieved; (B) the posterior wedge space was closed with appropriate opening of the anterior column; (C) intra-operative imaging shows L1 Y shape osteotomy</p

Patient demographics.

<p>Patient demographics.</p

Relationship between the expression of FoxQ1 and EMT indicator proteins.

*<p><i>P</i><0.05.</p

Additional file 1: of Cloning and characterization of enoate reductase with high β-ionone to dihydro-β-ionone bioconversion productivity

Sequence of DBR1, DBR2, BacOYE1, and CL2687.Contig2_ALL. (DOCX 24 kb

Long-term simulated health outcomes and costs.

<p>Long-term simulated health outcomes and costs.</p