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Related Concept Videos

Vertebral Column: Regions and Curvature01:16

Vertebral Column: Regions and Curvature

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The vertebral column or spine is a flexible column that supports the head, neck, and body and  allows for their movements. It also protects the spinal cord.
Regions of the Vertebral Column
In an adult, the spine is subdivided into five regions: the cervical, the thoracic, the lumbar, the sacral, and the coccygeal region. The spine initially develops as a series of 33 vertebrae; after 20 years of age, the nine bones in the sacral region, five sacral, and four coccygeal bones fuse to form...
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Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
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Osteotomies/spinal column resection in paediatric deformity.

Bahadir Gokcen1, Caglar Yilgor, Ahmet Alanay

  • 1Department of Orthopaedics and Traumatology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
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Spine osteotomies correct rigid paediatric spinal deformities when other methods fail. Experienced surgeons select techniques like Ponte or Smith-Petersen osteotomies for optimal spinal balance and growth.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Spine Deformities
  • Spinal Biomechanics

Background:

  • Paediatric spinal deformities present unique challenges compared to adults.
  • Vertebral osteotomies are reserved for rigid deformities unresponsive to less invasive treatments.
  • Surgical goals include deformity correction, halting progression, preserving growth, and enhancing pulmonary function.

Purpose of the Study:

  • To review various vertebral osteotomy techniques for paediatric spinal deformities.
  • To discuss the indications, prerequisites, and potential complications of each osteotomy type.
  • To guide the selection of appropriate osteotomy based on clinical and radiological factors.

Main Methods:

  • Review of established vertebral osteotomy procedures.
  • Discussion of surgical decision-making criteria.
  • Emphasis on the importance of neuromonitoring during surgery.

Main Results:

  • Several osteotomy techniques exist: Ponte, Smith-Petersen, pedicle subtraction, bone-disc-bone, and vertebral column resection.
  • Each technique is technically demanding and requires careful patient selection.
  • Successful outcomes depend on surgeon experience and tailored approach.

Conclusions:

  • Spine osteotomies are effective for complex paediatric spinal deformities.
  • Appropriate technique selection is crucial for achieving sagittal and coronal balance.
  • Outcomes are optimized when performed by experienced surgical teams with neuromonitoring.