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Related Concept Videos

  1. Home
  3. Research Domains
  5. Health Sciences
  7. Allied Health And Rehabilitation Science
  9. Orthoptics
  11. Less Is More: Complication Rates And Outcome Measures Of Intradiscal Osteotomy Versus Pedicle Subtraction Osteotomy In Adult Spinal Deformity.
  1. Home
  3. Research Domains
  5. Health Sciences
  7. Allied Health And Rehabilitation Science
  9. Orthoptics
  11. Less Is More: Complication Rates And Outcome Measures Of Intradiscal Osteotomy Versus Pedicle Subtraction Osteotomy In Adult Spinal Deformity.

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Less is more: complication rates and outcome measures of intradiscal osteotomy versus pedicle subtraction osteotomy in adult spinal deformity.

César Carballo Cuello1, Gabriel Flores-Milan1, Ryan Screven1

  • 11Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa.

Journal of Neurosurgery. Spine
|June 13, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Intradiscal osteotomy (IDO) effectively restores lordosis and corrects sagittal vertical axis (SVA) in spinal deformity patients. This technique offers improved outcomes and a comparable safety profile to pedicle subtraction osteotomy (PSO).

Keywords:
IDOPSOSVAadult spinal deformity

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Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Spinal deformity correction

Background:

  • Intradiscal osteotomy (IDO) is a surgical technique for spinal deformities, involving a three-column release to create lordosis.
  • IDO is considered a potential alternative to pedicle subtraction osteotomy (PSO) for restoring sagittal balance.

Purpose of the Study:

  • To compare the effectiveness and safety of IDO versus PSO in patients undergoing long construct fusions for lumbar degenerative disease.
  • To evaluate the impact of each technique on sagittal balance restoration, complication rates, and patient-reported outcomes.

Main Methods:

  • Retrospective database review of 53 patients who underwent long construct fusions (L2 or higher to S1/pelvis) between 2016 and 2022.
  • Patients had lumbar degenerative disease, preoperative fusion evidence, and a minimum 2-year follow-up.
intradiscal osteotomy
pedicle subtraction osteotomy
  • Comparison between 28 IDO patients and 25 PSO patients.

    • Main Results:

    • Both IDO and PSO demonstrated comparable rates of proximal junctional kyphosis (PJK), hardware failure (HF), deep vein thrombosis (DVT), wound infection, and pseudarthrosis.
    • IDO group showed a significantly better postoperative sagittal vertical axis (SVA) at 5 cm versus 7 cm for PSO (p=0.01).
    • IDO resulted in less postoperative back pain (p=0.01), reduced operative time (7 vs 8.5 hours; p=0.01), and lower estimated blood loss (800 vs 1400 ml; p=0.01).

    Conclusions:

    • Intradiscal osteotomy (IDO) is an effective technique for lordosis restoration and sagittal vertical axis (SVA) correction in spinal deformity surgery.
    • IDO offers significant advantages over pedicle subtraction osteotomy (PSO) in terms of reduced postoperative pain, operative time, and blood loss.
    • IDO presents a similar risk profile to PSO, making it a viable and potentially superior alternative for select patients.