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European Spine Journal
Published in: European Spine Journal 1/2015

01-01-2015 | Review Article

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

Authors: Riccardo Cecchinato, Pedro Berjano, Maryem-Fama Ismael Aguirre, Claudio Lamartina

Published in: European Spine Journal | Special Issue 1/2015

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Abstract

Introduction

Degenerative scoliosis is a three-dimensional deformity that can present in some instances with fixed sagittal and coronal imbalance. Pedicle subtraction osteotomy (PSO) is an effective technique that allows correction with a posterior approach. When a combined coronal and sagittal imbalance is present, asymmetric PSOs could be an optimal choice to correct deformity on both planes.

Methods

The asymmetric wedge resected from the vertebral body has to be shorter in the side of coronal imbalance, while a higher side cut has to be performed in the site opposite to the coronal imbalance. This allows to restore both coronal and sagittal alignment after osteotomy closure. An adequate preoperative planning is mandatory to correctly assess the geometry of the wedge to obtain the necessary correction.

Conclusions

The few studies present in literature show good results in terms of correction, even if the difficulty of this technique is certain.
Literature
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Metadata
Title
Asymmetrical pedicle subtraction osteotomy in the lumbar spine in combined coronal and sagittal imbalance
Authors
Riccardo Cecchinato
Pedro Berjano
Maryem-Fama Ismael Aguirre
Claudio Lamartina
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 1/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3669-0

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