Pedicle Lengthening Osteotomy for Lumbar Spinal Stenosis: A Systematic Review of Cadaveric, Computational, and Clinical Outcomes

Study Design: Systematic Review. Objective: To review the available published literature relating to pedicle lengthening osteotomy (PLO) for lumbar spinal stenosis (LSS), and to compare this technique to existing surgical options. Methods: PubMed/MEDLINE, Embase, and Scopus were reviewed using the keywords: “pedicle lengthening”, “lumbar”, and “spinal stenosis.” Results were reviewed for relevance and included only if they met inclusion criteria. The SYRCLE checklist was used to assess for sources of bias. Results: Inclusion criteria were biomechanical or clinical studies evaluating PLO for LSS. A total of 56 studies were identified in the Pubmed/MEDLINE database using the above-mentioned search criteria. Additionally, a total of 83 abstracts were reviewed in Embase, and 76 abstracts were reviewed in Scopus. After screening, 7 articles met inclusion criteria. Conclusions: PLO is a percutaneous, minimally invasive technique that has been described for the treatment of LSS. Biomechanical studies demonstrate significant enlargements in spinal canal dimensions and improvements in patient reported outcome measures while maintaining kinematic properties similar to the intact spine. Although overall sample size remains small, available data regarding PLO performed for LSS have shown encouraging early results.