The Nuances of Pedicle Subtraction Osteotomies

Sachin Gupta, Munish C. Gupta

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


In adult spinal deformity, the pedicle subtraction osteotomy is a useful technique to provide correction, especially in rigid, previously fused spines. However, it is not without its complications. In an effort to prevent pseudoarthrosis, a new technique using 4 rods has been pioneered to decrease stress on the 2 long rods while allowing for maintenance of correction with 2 smaller rods. One should also use careful neuromonitoring, especially during closure, to be able to make adjustments in time to prevent the development of neurologic deficits. Nevertheless, significant correction can be achieved and patients’ functional outcomes can be greatly improved.

Original languageEnglish
Pages (from-to)355-363
Number of pages9
JournalNeurosurgery clinics of North America
Issue number3
StatePublished - Jul 2018


  • Deformity
  • Four-rod technique
  • Pedicle subtraction osteotomy
  • Pseudoarthrosis
  • Rod failures


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