Spinal osteotomies: indications, limits and pitfalls

EFORT Open Reviews
Kamil Cagri KoseServet Igrek

Abstract

The aims of spinal deformity surgery are to achieve balance, relieve pain and prevent recurrence or worsening of the deformity.The main types of osteotomies are the Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO), bone-disc-bone osteotomy (BDBO) and vertebral column resection (VCR), in order of increasing complexity.SPO is a posterior column osteotomy in which the posterior ligaments and the facet joints are removed and correction is performed through the disc space. A mobile anterior disc is essential. SPO is best in patients with +6-8 cm C7 plumbline. The amount of correction is 9.3° to 10.7°/level (1°/mm bone).PSO is a technique where the posterior elements and pedicles are removed. Then a triangular wedge through the pedicles is removed and the posterior spine is shortened using the anterior cortex as a hinge. The ideal candidates are patients with a severe sagittal imbalance. A single level osteotomy can produce 30° 40° of correction. A single level osteotomy may restore global sagittal balance by an average of 9 cm with an upper limit of 19 cm.BDBO is an osteotomy done above and below a disc level. A BDBO provides correction rates in the range of 35° to 60°. The main indications are deformities with th...Continue Reading

References

Jun 1, 1991·Journal of Spinal Disorders·O Boachie-Adjei, D S Bradford
Mar 9, 2000·Spine·M TokunagaH Moriya
Sep 17, 2004·Acta Orthopaedica Scandinavica·Unsal DomanicAzmi Hamzaoglu
Jul 19, 2005·Spine·Se-Il SukWon-Kee Choi
Sep 4, 2009·Clinical Orthopaedics and Related Research·Lawrence G LenkeKathy M Blanke
May 12, 2012·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·Meric EnercanAhmet Alanay

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Citations

May 8, 2018·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·Michael M SafaeeAaron J Clark
Jan 30, 2019·JBJS Reviews·Ahmed AliAlexander Sheriff Montgomery
May 23, 2020·BMC Musculoskeletal Disorders·Austin Samuel Laifun LimJason Pui Yin Cheung
May 19, 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·Zifang HuangJunlin Yang

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