Spinal Deformity for Residents-Posterior Osteotomies

Video Transcription

Video Summary

In this video, the speaker discusses different techniques for posterior osteotomy. They start by explaining the original Smith-Peterson osteotomy, which was an anterior column lengthening and posterior column shortening procedure. However, the modern Smith-Peterson osteotomy is a polysegmental wedge osteotomy, where the posterior facet joints are removed with midline lamina. This technique achieves 5 to 10 degrees per level of correction. The speaker emphasizes that this type of correction is only possible with some degree of flexibility in the spine. They then present a case of a 59-year-old woman with a previous fusion and pseudarthrosis who developed progressive kyphosis. The speaker performs a pedicle subtraction osteotomy (PSO) at L1, resulting in a good sagittal alignment correction. They also note an inadvertent anterior column lengthening during the PSO. The video ends with a demonstration of the surgical technique for PSO, including decompression, instrumentation, and closure. Overall, the video highlights the importance of choosing the appropriate osteotomy technique based on the type of spinal deformity and flexibility.

Asset Subtitle

Presented by Charles A. Sansur, MD, MHSc, FAANS

Keywords

posterior osteotomy

Smith-Peterson osteotomy

polysegmental wedge osteotomy

pedicle subtraction osteotomy

surgical technique