Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011:2011:415946.
doi: 10.4061/2011/415946. Epub 2011 Oct 4.

Acute reciprocal changes distant from the site of spinal osteotomies affect global postoperative alignment

Eric Klineberg  1 , Frank Schwab, Christopher Ames, Richard Hostin, Shay Bess, Justin S Smith, Munish C Gupta, Oheneba Boachie, Robert A Hart, Behrooz A Akbarnia, Douglas C Burton, Virginie Lafage
Affiliations

Acute reciprocal changes distant from the site of spinal osteotomies affect global postoperative alignment

Eric Klineberg et al. Adv Orthop. 2011.

Abstract

Introduction. Three-column vertebral resections are frequently applied to correct sagittal malalignment; their effects on distant unfused levels need to be understood. Methods. 134 consecutive adult PSO patients were included (29 thoracic, 105 lumbar). Radiographic analysis included pre- and postoperative regional curvatures and pelvic parameters, with paired independent t-tests to evaluate changes. Results. A thoracic osteotomy with limited fusion leads to a correction of the kyphosis and to a spontaneous decrease of the unfused lumbar lordosis (-8°). When the fusion was extended, the lumbar lordosis increased (+8°). A lumbar osteotomy with limited fusion leads to a correction of the lumbar lordosis and to a spontaneous increase of the unfused thoracic kyphosis (+13°). When the fusion was extended, the thoracic kyphosis increased by 6°. Conclusion. Data from this study suggest that lumbar and thoracic resection leads to reciprocal changes in unfused segments and requires consideration beyond focal corrections.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Sagittal spinal radiological parameters.
Figure 2
Figure 2
Pelvic parameters.
Figure 3
Figure 3
Resection distribution by vertebral level.
Figure 4
Figure 4
Thoracic resection, limited fusion.
Figure 5
Figure 5
Thoracic resection, extended fusion to the lumbar spine.
Figure 6
Figure 6
Lumbar resection, limited fusion.
Figure 7
Figure 7
Lumbar resection, extended fusion to the thoracic spine.
See this image and copyright information in PMC

References

    1. Bridwell KH. Decision making regarding Smith-Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine. 2006;31(supplement 19):S171–S178. - PubMed
    1. Bridwell KH, Lewis SJ, Edwards C, et al. Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine. 2003;28(18):2093–2101. - PubMed
    1. Bridwell KH, Lewis SJ, Lenke LG, Baldus C, Blanke K. Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. Journal of Bone and Joint Surgery A. 2003;85(3):454–463. - PubMed
    1. Bridwell KH, Lewis SJ, Lenke LG, Baldus C, Blanke K. Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. Surgical technique. Journal of Bone and Joint Surgery A. 2004;86(supplement 1):44–50. - PubMed
    1. Buchowski JM, Bridwell KH, Lenke LG, et al. Neurologic complications of lumbar pedicle subtraction osteotomy: a 10-year assessment. Spine. 2007;32(20):2245–2252. - PubMed

LinkOut - more resources