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Spinal osteotomies: indications, limits and pitfalls
Kamil Cagri Kose1, Omer Bozduman2, Ali Erkan Yenigul3
1Marmara University Faculty of Medicine Department of Orthopedics and Traumatology, Istanbul, Turkey.
EFORT Open Reviews
|May 17, 2017
Summary
Spinal deformity surgery aims to restore balance and relieve pain using various osteotomy techniques. The choice of osteotomy, from Smith-Petersen osteotomy to vertebral column resection, depends on the deformity
Area of Science:
- Orthopedic surgery
- Spinal surgery
- Surgical anatomy
Background:
- Spinal deformities require surgical intervention to correct alignment, alleviate pain, and prevent progression.
- Various osteotomy techniques exist, differing in complexity and application.
Purpose of the Study:
- To review the aims of spinal deformity surgery.
- To outline the main types of osteotomies used in spinal surgery.
- To discuss the indications and corrective potential of each osteotomy type.
Main Methods:
- Review of spinal deformity surgical aims.
- Description of four main osteotomy types: Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO), bone-disc-bone osteotomy (BDBO), and vertebral column resection (VCR).
- Discussion of indications, complexity, and correction capabilities for each technique.
Main Results:
- SPO corrects 9.3°-10.7°/level, suitable for C7 plumbline issues.
- PSO corrects 30°-40° per level for severe sagittal imbalance, restoring up to 9 cm of balance.
- BDBO corrects 35°-60° for disc-apex deformities; VCR addresses rigid multi-planar and sharp deformities.
Conclusions:
- Osteotomy selection is guided by deformity etiology, type, and apex.
- Techniques range from simpler SPO to complex VCR.
- Gradual progression from simpler to more complex osteotomies is a viable surgical strategy.
