TY - JOUR
T1 - Osteotomies in the posterior-only treatment of complex adult spinal deformity
T2 - A comparative review
AU - Dorward, Ian G.
AU - Lenke G., Lawrence G.
PY - 2010/3
Y1 - 2010/3
N2 - In addressing adult spinal deformities through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. The Ponte or Smith-Petersen osteotomy provides the least correction, but it can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies but carry increased technical demands, longer operative time, and greater blood loss and associated morbidity. Vertebral column resections serve as the most powerful method, providing the most correction in the coronal and sagittal planes, but posing both the greatest technical challenge and the greatest risk to the patient in terms of possible neurological injury, operative time, and potential morbidity. The authors reviewed the literature relating to these osteotomy methods. They also provided case illustrations and suggestions for their proper application.
AB - In addressing adult spinal deformities through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. The Ponte or Smith-Petersen osteotomy provides the least correction, but it can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies but carry increased technical demands, longer operative time, and greater blood loss and associated morbidity. Vertebral column resections serve as the most powerful method, providing the most correction in the coronal and sagittal planes, but posing both the greatest technical challenge and the greatest risk to the patient in terms of possible neurological injury, operative time, and potential morbidity. The authors reviewed the literature relating to these osteotomy methods. They also provided case illustrations and suggestions for their proper application.
KW - Kyphosis correction
KW - Pedicle subtraction
KW - Posterior-only approach
KW - Smith-Petersen Adult deformity
KW - Spinal osteotomy
KW - Vertebral column resection Ponte
UR - http://www.scopus.com/inward/record.url?scp=77951893701&partnerID=8YFLogxK
U2 - 10.3171/2009.12.FOCUS09259
DO - 10.3171/2009.12.FOCUS09259
M3 - Article
C2 - 20192665
AN - SCOPUS:77951893701
VL - 28
SP - 1
EP - 10
JO - Neurosurgical Focus
JF - Neurosurgical Focus
SN - 1092-0684
IS - 3
ER -