The Journal of Bone and Joint Surgery (American). 2008;90:2509-2520.
doi:10.2106/JBJS.H.00081
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Corrective Osteotomies in Spine Surgery

J. Brian Gill, MD, MBA1, Andrew Levin, BS2, Tim Burd, MD1 and Michael Longley, MD1

1 Nebraska Foundation for Spinal Research, 11819 Miracle Hills Drive, Suite 102, Omaha, NE 68154. E-mail address for J.B. Gill: jbgill{at}nebraskaspinecenter.com
2 Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Spinal deformities can result in increasing thoracic kyphosis or loss of lumbar lordosis, leading to imbalance in the sagittal plane. Such deformities can be functionally and psychologically debilitating.

The Smith-Petersen osteotomy can achieve approximately 10° of correction in the sagittal plane at each spinal level at which it is performed. This osteotomy is beneficial for patients who have a degenerative imbalance in the sagittal plane.

The pedicle subtraction osteotomy can achieve approximately 30° to 40° of correction in the sagittal plane at each spinal level at which it is performed. It is the preferred osteotomy for patients with ankylosing spondylitis who have an imbalance of the spine in the sagittal plane.

The cervical extension osteotomy is performed in the cervical spine, at the cervicothoracic junction, in patients who have a cervical flexion deformity that impedes their ability to look straight ahead while walking or who have difficulty swallowing.

The vertebral column resection is used when the imbalance is severe enough that the other osteotomies cannot correct the deformity, especially in patients who have a combined sagittal and coronal spinal imbalance.

Neurologic problems, whether transient or permanent, are the most commonly encountered complications following these procedures.

Recent results have shown a high patient satisfaction rate and good functional outcomes after spinal osteotomies done to treat a variety of disorders.


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