On the pedicle subtraction osteotomy technique and its modifications during the past two decades: a complementary classification to the Schwab's spinal osteotomy classification.

Spine Deformity
Anouar BourghliIbrahim Obeid

Abstract

To propose a complementary classification to the Schwab's osteotomy classification that would regroup together under a common umbrella different published pedicle subtraction osteotomy (PSO) variations that are commonly used, to have a common language and complete the spine surgeon's armamentarium when dealing with rigid spinal deformities. The 2 general types corresponding to the grades 3 and 4 of the Schwab classification were separated into 6 gradual subtypes (grades 3A, 3B, 3C, 4A, 4B, 4C). The classification is based on the amount of resected pedicle, the inclusion or not of the disc above, and the location of the axis of rotation. Based on the proposed classification, a reliability study was performed using 18 cases that were classified by 8 readers with expertise in the management of adult deformities with the use of osteotomies. Clinical cases were classified according to the 6 grades proposed in the classification. The intra-rater reliability for the classification was "almost perfect agreement" with a Fleiss kappa coefficient average of 0.92 (range 0.85-1.00). The inter-rater reliability was "almost perfect agreement" with a coefficient average of 0.90 for the 2 readings that were done at an interval of 2 weeks. The d...Continue Reading

References

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Sep 30, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Anouar BourghliIbrahim Obeid

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