The Influence of Closing-Opening Wedge Osteotomy on Sagittal Balance in Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis
Bibliographic record
Abstract
In Brief Study Design. A retrospective study. Objective. To compare the radiographical and clinical outcomes between closing wedge osteotomy (CWO) and closing-opening wedge osteotomy (COWO) for thoracolumbar kyphosis secondary to ankylosing spondylitis. Summary of Background Data. Several surgical techniques have been used to correct the fixed thoracolumbar kyphosis caused by ankylosing spondylitis. To date, the comparison of the outcomes between CWO and COWO has not yet been addressed. Methods. According to the association with anterior edge opening or not shown on the postoperative radiographs, 64 patients were divided into 2 groups (35 patients in the CWO group and 29 patients in the COWO group). The radiographical and clinical outcomes were compared between the 2 groups, with a mean follow-up of 36 months (range, 24–84 mo). Radiographical measurements included thoracic kyphosis, lumbar lordosis, global kyphosis, sagittal vertical axis, osteotomized vertebra angle, and the height of the osteotomized vertebra. Oswestry Disability Index was evaluated at the final follow-up. Results. Thoracic kyphosis did not change significantly between postoperatively and the final follow-up in both groups. The mean corrections of lumbar lordosis, global kyphosis, sagittal vertical axis, and osteotomized vertebra angle were significantly larger in the COWO group than in the CWO group (P < 0.05). Notably, statistically significant differences (P < 0.05) were observed in the variation of height of the osteotomized vertebra (1.3 cm in the CWO group vs. 0.7 cm in the COWO group). In both groups, no patients had pseudarthrosis at the osteotomy level at the last follow-up. There was no significant difference of Oswestry Disability Index scores between the 2 groups at the final follow-up. Conclusion. Both CWO and COWO are safe and effective surgical methods for correction of thoracolumbar kyphosis. COWO can obtain larger correction and better sagittal alignment without additional neurological complications. This study focuses on the comparison of the radiographical and clinical outcomes between closing wedge osteotomy and closing-opening wedge osteotomy for thoracolumbar kyphosis secondary to ankylosing spondylitis. The results of this study suggest that closing-opening wedge osteotomy can achieve better correction than closing wedge osteotomy without additional neurological complications in patients with ankylosing spondylitis with fixed thoracolumbar kyphosis and sagittal imbalance.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".