Clinical and radiological outcomes of posterior closing wedge osteotomy in post-tubercular thoracolumbar kyphosis.

Abstract

Objective: To critically evaluate the clinical, radiographic and neurological outcomes after posterior closing wedge osteotomy (PCWO) in persons suffering from post-tubercular kyphosis (PTK). Study Design: Quasi-experimental study. Setting: Department of Orthopaedic Surgery in the Lahore General Hospital. Period: February 2021 to January 2022. Methods: This was a quasi-experimental study in which thirty patients with Post-Tubercular Kyphosis were treated by Posterior Closing Wedge Osteotomy. Clinical function was measured by the Oswestry Disability Index (ODI), the neurological status was graded according to the Frankel classification, and radiologic correction was assessed according to Cobb's angle measured from lateral spinal radiographs. Results: The mean age of the cohort of patients was between 25 and 40 years, with a predominance of female patients 60%. Cobb's angle showed a statistically significant reduction from baseline to final follow-up (p < .05). Neurological recovery was noted in most patients, with most reaching Frankel grade E at final follow-up. ODI scores indicated a significant functional improvement over time (p < .05). Complications were mostly low-grade (Dindo-Clavien Grade I), with only one grade III in one patient (3.3%). Conclusion: Posterior closing wedge osteotomy is a safe and effective surgical modality for correction of post-tuberculous kyphosis with promising results in terms of significant deformity correction, neurological restitution and functional enhancement.