Tag: SVA

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Less is more: complication rates and outcome measures of intradiscal osteotomy versus pedicle subtraction osteotomy in adult spinal deformity

J Neurosurg Spine 43:313–323, 2025

In adults with spinal deformity, intradiscal osteotomy (IDO) is as effective as pedicle subtraction osteotomy (PSO) for lordosis restoration and sagittal balance, with similar complication rates but significantly less blood loss, shorter operative time, and less postoperative back pain at 3 months.

• Intradiscal osteotomy (IDO) and pedicle subtraction osteotomy (PSO) are both used to correct adult spinal deformity, aiming to restore lumbar lordosis and sagittal balance.

• IDO and PSO showed similar fusion rates and complication profiles, with no statistically significant difference in rates of proximal junctional kyphosis, hardware failure, DVT, wound infection, or pseudarthrosis.

• IDO resulted in significantly less estimated blood loss (800 ml vs. 1400 ml) and shorter operative time (7 vs. 8.5 hours) compared to PSO.

• IDO patients reported less back pain at 3 months post-op (VAS 1 vs. 3, p=0.01) than PSO patients.

• Both techniques effectively restored lumbar lordosis, but IDO achieved better postoperative sagittal vertical axis (SVA) correction (5 cm vs. 7 cm, p=0.01).

• Higher BMI was a significant risk factor for postoperative complications in both groups.

• IDO is less technically complex, preserves vertebral body integrity, and is more familiar to spine surgeons than PSO.

• IDO can be considered an effective and potentially safer alternative to PSO for selected adult spinal deformity patients.

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Cervical Spine Deformity—Part 3: Posterior Techniques, Clinical Outcome, and Complications

Neurosurgery 81:893–898, 2017

The goals of cervical deformity surgery include deformity correction, restoration of horizontal gaze, decompression of neural elements, spinal stabilization with a biomechanically sound construct, and meticulous arthrodesis technique to prevent pseudoarthrosis and minimizing surgical complications.

Many different surgical options exist, but selecting the correct approach that ensures the optimal clinical outcome can be challenging and often controversial. In this last part of the cervical deformity review series, various posterior deformity correction techniques are discussed in detail, along with an overview of surgical outcome and postoperative complications.

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Cervical Spine Deformity—Part 2: Management Algorithm and Anterior Techniques

Neurosurgery 81:561–567, 2017

A sound operative plan based on solid understanding of the pathology and biomechanics is the most important part of cervical deformity correction.

Many different surgical options exist for operative management of cervical spine deformities. However, selecting the correct approach that ensures the optimal clinical outcome can be challenging and often controversial.

In Part 2 of this three-part review series, we discuss the pre-operative planning, management algorithm, and anterior surgical techniques for cervical deformity correction.

 

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