Asymmetrical Pedicle Subtraction Osteotomy for Rigid Degenerative Lumbar Kyphoscoliosis

Abstract

Our data suggest that the surgical procedure of asymmetrical PSO is to correct the scoliosis, to restore the lumbar lordosis by way of convex-sided posterolateral wedge osteotomy, and may go a long way toward solving the problems of rigid lumbar degenerative kyphoscoliosis.

Evaluation of the location of intervertebral cages during oblique lateral interbody fusion surgery to achieve sagittal correction

“…These mixed-up pathologies can affect the incidence of the endplate injury. These pathologies can can influence the rate of correction loss at the fused intervertebral space by different mechanism, which can result in the relatively small correction angle of 3.8 considering the lordotic angle of the cage (6 ). On the other hand, the current study provides the comprehensive data regarding the concept on the lordotic correction using OLIF cage according to its location.…”

“…Sometimes more invasive corrective osteotomy surgeries such as pedicle subtraction osteotomy 6) or vertebral column resection 7,8) are performed to achieve more dramatic LL correction, but these procedures are invasive and associated with massive hemorrhaging after osteotomy and epidural bleeding [9][10][11] . Surgical procedures associated with effective sagittal alignment correction other than posterior surgery include anterior lumbar interbody fusion and lumbar lateral interbody fusion (LLIF), which enables surgeons to approach the anterior spine with the least amount of exposure and perform anterior column interbody fusion by using cages designed for oblique or lateral placement.…”

The Sagittal Balance Does not Influence the 1 Year Clinical Outcome of Patients With Lumbar Spinal Stenosis Without Obvious Instability After Microsurgical Decompression

“…13 Several operative techniques were proposed to address the sagittal reconstruction. [14][15][16][17] Patients, who received dorsal instrumentation, have benefi ted from restoration of their sagittal alignment. [18][19][20] Thus, the sagittal spinal confi guration infl uences clinical decision making in degenerative spine disease and many authors recommend routine restoration of sagittal alignment and SB, if any kind of surgery for degenerative spine disease is considered.…”

Asymmetrical pedicle subtraction osteotomy in the lumbar spine in combined coronal and sagittal imbalance

“…For these reasons, asymmetric PSO is considered a valid alternative to such an invasive procedure as VCR, showing, however, adequate corrective properties of deformities on both sagittal and coronal planes. Some papers on asymmetric PSO series and technical description [7,10] and an interesting OOT video [11] can further illustrate this particular and rarely performed osteotomy.…”

“…In a prospective paper, Toyone [7] analyzed 14 patients who underwent corrective asymmetric PSO. The findings were that this technique provided an appreciable correction of the scoliosis and a correction of lumbar lordosis using a convex-sided posterolateral wedge resection.…”