A new technique for subtotal (cranial wedge) ostectomy in the treatment of impinging/overriding spinous processes: description of technique and outcome of 25 cases.

The research study presents a new surgery technique – subtotal (cranial wedge) ostectomy – as an efficient and less complicated method for treating overriding spinous processes of the thoracolumbar vertebrae. The outcomes revealed in the study are based on 25 cases treated at Newmarket Equine Hospital from 2009 to 2011.

Study Aim

The primary aim of the study was to evaluate the effectiveness of using subtotal (cranial wedge) ostectomy as treatment for overriding spinous processes. Specifically, they wanted to understand whether this procedure:

• Leads to a short surgery time and low complication rates
• Maintains the contour of the spine
• Provides a better, both functionally and cosmetically, outcome compared to the previously used surgical techniques

Research Method

The researchers undertook a retrospective study where methods for a new surgical procedure were described. Following that, they closely inspected the records of 25 patients who had undergone the procedure. As part of the analysis, they reviewed the following:

• Anamnesis
• Clinical findings
• Details of surgical and post-operative management

The researchers then surveyed the patients regarding functional and cosmetic results.

Research Findings

The findings concluded that of the patients treated using this technique:

• 78.9% experienced resolution of clinical signs and returned to full work
• 18.2% experienced improvement
• 81.8% described the cosmetic outcome as excellent, with the remainder rating it as good
• Surgery time ranged from 20 to 70 minutes with a median of 30 minutes
• There were no intra- or post-operative complications

Conclusion

The researchers inferred that compared to previous surgical techniques, subtotal (cranial wedge) ostectomy has several advantages. It only removes the impinging portions of the SPs, maintains the spine’s contour, facilitates access, enables a shorter surgery time, and enjoys fewer complications. Despite these advantages, the functional outcomes are similar to those of more invasive procedures.