APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGFei ^1,2 ,  TAOHuiren ¹ , LIUZhibin ² , ZHANGJianhua ² , HANFangmin ²

1. Department of Orthopedics, Affiliated Xijing Hospital of Fourth Military Medical University, Xi'an Shaanxi, 710032, P. R. China;
2. Department of Spinal Surgery, Yan'an University Affiliated Hospital;

Corresponding?author：

TAOHuiren, Email: huirentao@fmmu.edu.cn

Keywords：

Photoshop CS16.0 software; Thoracolumbar kyphotic deformity; Ankylosing spondylitis; Osteotomy design

DOI：

10.7507/1002-1892.20150040

Video：

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Objective To introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. Methods Between March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). Results No complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P<0.05), but no significant difference was found between at 1 week and last follow-up (P>0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2±10.5)° and (33.7±9.7)° respectively, showing no significant difference (t=0.84, P=0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P<0.05), but no significant difference was found between at 1 week and last follow-up (P>0.05). At last follow-up, no failures of internal fixation was found, and bony fusion was obtained. Conclusion The preoperative osteotomy design by using PS software can precisely recover the spinal sagittal balance and horizontal angle of view, so it can effectively avoid excessive correction and insufficient correction of the deformity and obtain good effectiveness in treating ASK.

Citation： WANGFei, TAOHuiren, LIUZhibin, ZHANGJianhua, HANFangmin. APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(2): 184-188. doi: 10.7507/1002-1892.20150040 Copy

1.	Kiaer T, Gehrchen M. Transpedicular closed wedge osteotomy in ankylosing spondylitis:results of surgical treatment and prospective outcome analysis. Eur Spine J, 2009, 19(1):57-64.
2.	Sengupta R, Stone MA. The assessment of ankylosing spondylitis in clinical practice. Nat Clin Pract Rheumatol, 2007, 3(9):496-503.
3.	肖聯平, 江毅, 劉智, 等. 強直性脊柱炎后凸畸形的外科治療. 中國脊柱脊髓雜志, 2004, 14(9):527-530.
4.	李景欣, 瞿東濱, 王博亮, 等. 計算機輔助設計在強直性脊柱炎后凸畸形矯形手術中的應用. 中國臨床解剖學雜志, 2008, 26(6):619-623.
5.	Aurouer N, Obeid I, Gille O, et al. Computerized preoperative planning for correction of sagittal deformity of the spine. Surg Radiol Anat, 2009, 31(10):781-792.
6.	van Royen J, Scheerder FJ, Jansen E, et al. ASKyphoplan:a program for deformity planning in ankylosing spondylitis. Eur Spine J, 2007, 16(9):1445-1449.
7.	Song K, Zheng G, Zhang Y, et al. Hilus pulmonis as the center of gravity for AS thoracolumbar. Eur Spine J, 2014, 23(12):2743-2750.
8.	Yang BP, Ondra SL. A method for calculating the exact angle required during pedicle subtraction osteotomy for fixed sagittal deformity:comparison with the trigonometric method. Neurosurgery, 2006, 59(4 Suppl 2):ONS458-463.
9.	Suk KS, Kim KT, Lee SH, et al. Significance of chin-brow vertical angle in correction of kyphotic deformity of ankylosing spondylitis patients. Spine (Phila Pa 1976), 2003, 28(17):2001-2005.
10.	Schwab F, Patel A, Ungar B, et al. Adult spinal deformity-postoperative standing imbalance:how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976), 2010, 35(25):2224-2231.
11.	徐輝, 張永剛, 毛克亞, 等. 經椎弓根截骨術治療強直性脊柱炎后凸畸形. 中國修復重建外科雜志, 2013, 27(4):389-392.
12.	Chung JY, Kamath V, Avadhani A, et al. Ankylosing spondylitis neural and sparing osteotomy. Eur Spine J, 2010, 19(2):337-338.
13.	Van Royen BJ, Slot GH. Closing-wedge posterior osteotomy for ankylosing spondylitis. Partial corporectomy and transpedicular fixation in 22 cases. J Bone Joint Surg (Br), 1995, 77(1):117-121.
14.	Mac-Thiong JM, Labelle H, Berthonnaud E, et al. Sagittal spinopelvic balance in normal children and adolescents. Eur Spine J, 2007, 16(2):227-234.
15.	Tanguay F, Mac-Thiong JM, de Guise JA, et al. Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis. Eur Spine J, 2007, 16(4):531-536.
16.	Legaye J, Duval-Beaupère G, Hecquet J, et al. Pelvic incidence:a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J, 1998, 7(2):99-103.
17.	邱勇, 殷剛, 曹興兵, 等. 特發性胸椎側凸患者的胸椎后凸狀態對腰骶椎矢狀面形態的影響. 中華外科雜志, 2008, 46(16):1237-1240.
18.	Le Huec JC, Leijssen P, Duarte M, et al. Thoracolumbar imbalance analysis for osteotomy planification using a new method:FBI technique. Eur Spine J, 2011, 20 Suppl 5:669-680.

1. Kiaer T, Gehrchen M. Transpedicular closed wedge osteotomy in ankylosing spondylitis:results of surgical treatment and prospective outcome analysis. Eur Spine J, 2009, 19(1):57-64.
2. Sengupta R, Stone MA. The assessment of ankylosing spondylitis in clinical practice. Nat Clin Pract Rheumatol, 2007, 3(9):496-503.
3. 肖聯平, 江毅, 劉智, 等. 強直性脊柱炎后凸畸形的外科治療. 中國脊柱脊髓雜志, 2004, 14(9):527-530.
4. 李景欣, 瞿東濱, 王博亮, 等. 計算機輔助設計在強直性脊柱炎后凸畸形矯形手術中的應用. 中國臨床解剖學雜志, 2008, 26(6):619-623.
5. Aurouer N, Obeid I, Gille O, et al. Computerized preoperative planning for correction of sagittal deformity of the spine. Surg Radiol Anat, 2009, 31(10):781-792.
6. van Royen J, Scheerder FJ, Jansen E, et al. ASKyphoplan:a program for deformity planning in ankylosing spondylitis. Eur Spine J, 2007, 16(9):1445-1449.
7. Song K, Zheng G, Zhang Y, et al. Hilus pulmonis as the center of gravity for AS thoracolumbar. Eur Spine J, 2014, 23(12):2743-2750.
8. Yang BP, Ondra SL. A method for calculating the exact angle required during pedicle subtraction osteotomy for fixed sagittal deformity:comparison with the trigonometric method. Neurosurgery, 2006, 59(4 Suppl 2):ONS458-463.
9. Suk KS, Kim KT, Lee SH, et al. Significance of chin-brow vertical angle in correction of kyphotic deformity of ankylosing spondylitis patients. Spine (Phila Pa 1976), 2003, 28(17):2001-2005.
10. Schwab F, Patel A, Ungar B, et al. Adult spinal deformity-postoperative standing imbalance:how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976), 2010, 35(25):2224-2231.
11. 徐輝, 張永剛, 毛克亞, 等. 經椎弓根截骨術治療強直性脊柱炎后凸畸形. 中國修復重建外科雜志, 2013, 27(4):389-392.
12. Chung JY, Kamath V, Avadhani A, et al. Ankylosing spondylitis neural and sparing osteotomy. Eur Spine J, 2010, 19(2):337-338.
13. Van Royen BJ, Slot GH. Closing-wedge posterior osteotomy for ankylosing spondylitis. Partial corporectomy and transpedicular fixation in 22 cases. J Bone Joint Surg (Br), 1995, 77(1):117-121.
14. Mac-Thiong JM, Labelle H, Berthonnaud E, et al. Sagittal spinopelvic balance in normal children and adolescents. Eur Spine J, 2007, 16(2):227-234.
15. Tanguay F, Mac-Thiong JM, de Guise JA, et al. Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis. Eur Spine J, 2007, 16(4):531-536.
16. Legaye J, Duval-Beaupère G, Hecquet J, et al. Pelvic incidence:a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J, 1998, 7(2):99-103.
17. 邱勇, 殷剛, 曹興兵, 等. 特發性胸椎側凸患者的胸椎后凸狀態對腰骶椎矢狀面形態的影響. 中華外科雜志, 2008, 46(16):1237-1240.
18. Le Huec JC, Leijssen P, Duarte M, et al. Thoracolumbar imbalance analysis for osteotomy planification using a new method:FBI technique. Eur Spine J, 2011, 20 Suppl 5:669-680.

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APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS

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