A study published in the Journal of Neurosurgery: Spine examines the pedicle subtraction osteotomy technique for spinal deformity, a mini-open approach.
The researchers examined 16 patients with severe coronal and/or sagittal-plane deformity. The patients underwent single-level PSO or extended PSO at L2 or L3 with percutaneous instrumentation fixation and interbody or facet joint fusions at the remaining levels.
All procedures were the mini-open technique and the patients were followed for 17.7 months on average. There was an average of 7.6 levels fused and half of the patients had bilateral screw fixation with constructs crossing the thoracolumbar and lumbosacral junctions.
Here are five key findings from the report:
1. The average operative time was 356 ± 50 minutes and the average blood loss was 843 ± 339.
2. The leg visual analog scale scores improved from 5.7 ± 2.7 to 1.3 ± 1.6. The back visual analog scale scores improved from 8.6 ± 1.3 to 2.4 ± 2.1.
3. The Oswestry Disability Index scores improved from 50.1 ± 14.4 on average to 16.4 ± 12.7. The SF-36 physical component summary scores went from 43.4 ± 2.6 to 47 ± 4.3. The SF-36 mental component changed from 46.7 ± 3.6 on average to 46.3 ± 3.
4. The coronal alignment improved from 27.9 ± 43.6 mm to 16 ± 17.2 mm on average. At the same time, the lumbar Cobb angle improved from 41.2 degrees ± 18.4 degrees to 15.4 degrees ± 9.6 degrees on average. The lumbar lordosis improved from 23.1 degrees ± 15.9 degrees to 48.6 degrees ± 11.7 degrees.
5. The pelvic tilt improved from 33.7 degrees ± 8.6 degrees on average to 24.4 degrees ± 6.5 degrees.
6. Four patients failed to achieve 10 degrees or less mismatch on the parameter; 10 patients underwent delayed postoperative CT and eight of those patients developed a solid arthrodesis at all treated levels.
7. Six complications occurred among this series of patients but there were no cases of symptomatic proximal junction kyphosis.
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