• Xuesong Zhang, Yao Wang, Bing Wu, Wenhao Hu, Zhifa Zhang, and Yan Wang.
• Department of Orthopaedics, General Hospital of Chinese People's Liberation Army, Fuxing Road 28, Beijing, 100853, China.
• Eur Spine J. 2016 Aug 1; 25 (8): 2587-95.

BackgroundAndersson lesion (AL) can occur in patients with ankylosing spondylitis (AS). Surgical instrumentation and fusion is considered the principle management in symptomatic AL that fails to resolve from a conservative treatment. However, there is significant controversy over the ideal management. The purpose of this study is to introduce our experience and explore the efficacy and feasibility of transpedicular subtraction and disc resection osteotomy technique for patients with AL-complicating AS.MethodsFrom January 2009 to January 2013, 17 consecutive patients with Andersson lesion-complicating ankylosing spondylitis treated with transpedicular subtraction and disc resection osteotomy technique were retrospectively reviewed. All patients completed a follow-up of at least 2 years.ResultsThe average surgical time was 219 min with a mean intraoperative blood loss of 876 ml. The average preoperative regional angle was 29.1°, 4.9° postoperatively, and 5.9° at the final follow-up. The global angle changed from 59.1° preoperatively to 24.7° after surgery with the sagittal vertical axis (SVA) changed from 153.7 to 41.1 mm. The mean VAS back pain scores decreased from 6.4 preoperatively to 1.1 postoperatively and the ODI score improved from 50.9 preoperatively to 16.9 at the final follow-up. Solid fusion was obtained in all patients.ConclusionThe transpedicular subtraction and disc resection osteotomy achieve satisfactory kyphosis correction, good fusion and favorable clinical outcomes with less blood loss and complications than other approaches, implying an alternative method in patients with Andersson lesion-complicating ankylosing spondylitis.

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