title: Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients.
abstract: In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The long-term overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided.
authors: Seung-Jae Hyun, Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 463-707, South Korea.
authors: Seung-Jae
authors: SJ
authors: Hyun
authors: Yongjung J
authors: YJ
authors: Kim
authors: Seung-Chul
authors: SC
authors: Rhim
keywords: Clinical outcome; Complication; Pedicle subtraction osteotomy; Proximal junctional kyphosis; Sagittal imbalance