@article {Z{\'a}rate-Kalf{\'o}pulos7040, author = {Bar{\'o}n Z{\'a}rate-Kalf{\'o}pulos and Luis Alberto Navarro-Aceves and Hugo Reynoso-Cant{\'u} and Alejandro Reyes-S{\'a}nchez and Carla Lissette Garc{\'\i}a-Ramos and Fernando Reyes-Tarrag{\'o} and Armando Alp{\'\i}zar-Aguirre}, title = {Posterior Grade 4 Osteotomy With Vertebral Shortening Is Effective for the Treatment of Kyphosis Associated With Vertebral Discitis/Osteomyelitis}, elocation-id = {7040}, year = {2020}, doi = {10.14444/7040}, publisher = {International Journal of Spine Surgery}, abstract = {Background In the retrospective study of a prospectively maintained database, we present a case series of patients with kyphotic deformity secondary to spinal infection treated using a posterior-only approach with 3-column shortening and posterior instrumentation.Methods This is a case series of patients presenting with postural deformity and sagittal imbalance treated consecutively by 1 surgeon between 2012 and 2014. Clinical assessments and radiographic evaluations were made preoperatively and at 12- and 24-month postoperative follow-ups. All patients underwent computed tomography 24 months after surgery to evaluate spinal fusion.Results The study included 5 patients with a mean age of 50 years (range, 32{\textendash}60 years). Three patients had comorbidities. Three patients were classified as American Spinal Injury Association (ASIA) grade C and were not ambulatory; 2 were ASIA grade D. At follow-up, all patients were ambulatory and classified as ASIA grade E. Kyphosis was corrected from a preoperative mean of 32{\textdegree} (range, 15{\textdegree}{\textendash}58{\textdegree}) to 10{\textdegree} (range, 1{\textdegree}{\textendash}42{\textdegree}) at the 2-year follow-up. A mean improvement of 22{\textdegree} and 75\% reduction in kyphosis was obtained with fixation 2 levels above and below the lesion. Interbody fusion was observed in all patients. No major complications occurred during surgery.Conclusions Posterior grade 4 osteotomy with vertebral shortening can be performed safely in patients with kyphosis associated with vertebral discitis/osteomyelitis in the thoracolumbar region. The single approach allowed the surgeon to debride the infection, correct the kyphosis, decompress the spinal canal, and stabilize the spine.Level of Evidence 4}, issn = {2211-4599}, URL = {http://www.ijssurgery.com/content/early/2020/06/17/7040}, eprint = {http://www.ijssurgery.com/content/early/2020/06/17/7040.full.pdf}, journal = {International Journal of Spine Surgery} }