Abdulmajeed Alzakri1,2, Louis Boissière3, Derek T Cawley3, Anouar Bourghli4, Vincent Pointillart3, Olivier Gille3, Jean-Marc Vital3, Ibrahim Obeid3. 1. Department of Spinal Surgery Unit 1, Université de Bordeaux, Bordeaux University Hospital, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076, Bordeaux, France. a.alzakri@gmail.com. 2. Orthopaedic Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia. a.alzakri@gmail.com. 3. Department of Spinal Surgery Unit 1, Université de Bordeaux, Bordeaux University Hospital, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076, Bordeaux, France. 4. Orthopedic and Spinal Surgery Department, Kingdom Hospital, Riyadh, Saudi Arabia.
Abstract
PURPOSE: To evaluate the radiographic, functional outcomes, complications and surgical specificities of L5 pedicle subtraction osteotomy for fixed sagittal and coronal malalignment. METHODS: A retrospective cohort of consecutive patients with prospectively collected data. Ten patients who underwent PSO at L5 were eligible for a 2-year minimum follow-up (average, 4.0 years). Patients were evaluated by standardized upright radiographs. Preoperative and postoperative radiographies, surgical data and complications were collected. RESULTS: All surgeries were revision surgeries. The mean lumbar lordosis before surgery was - 22.5° (range, 8° to - 33°) and improved to - 58.5° (range, - 40° to - 79°). The sagittal vertical axis demonstrated a preoperative mean sagittal malalignment of 13.7 cm (range 3.5 to 20 cm), with correction to 4.6 cm postoperatively. Three patients required additional surgery at the latest follow-up for rod breakage. CONCLUSIONS: PSO of L5 can be a safe and effective technique to treat and correct fixed sagittal imbalance and provide biomechanical stability. The high complication rate mandates a careful assessment of the risk/benefit ratio of such a major surgery. Most patients are satisfied, particularly when sagittal balance is achieved.
PURPOSE: To evaluate the radiographic, functional outcomes, complications and surgical specificities of L5 pedicle subtraction osteotomy for fixed sagittal and coronal malalignment. METHODS: A retrospective cohort of consecutive patients with prospectively collected data. Ten patients who underwent PSO at L5 were eligible for a 2-year minimum follow-up (average, 4.0 years). Patients were evaluated by standardized upright radiographs. Preoperative and postoperative radiographies, surgical data and complications were collected. RESULTS: All surgeries were revision surgeries. The mean lumbar lordosis before surgery was - 22.5° (range, 8° to - 33°) and improved to - 58.5° (range, - 40° to - 79°). The sagittal vertical axis demonstrated a preoperative mean sagittal malalignment of 13.7 cm (range 3.5 to 20 cm), with correction to 4.6 cm postoperatively. Three patients required additional surgery at the latest follow-up for rod breakage. CONCLUSIONS:PSO of L5 can be a safe and effective technique to treat and correct fixed sagittal imbalance and provide biomechanical stability. The high complication rate mandates a careful assessment of the risk/benefit ratio of such a major surgery. Most patients are satisfied, particularly when sagittal balance is achieved.
Authors: Steven D Glassman; Keith Bridwell; John R Dimar; William Horton; Sigurd Berven; Frank Schwab Journal: Spine (Phila Pa 1976) Date: 2005-09-15 Impact factor: 3.468
Authors: Keith H Bridwell; Stephen J Lewis; Charles Edwards; Lawrence G Lenke; Theresa M Iffrig; Annette Berra; Christine Baldus; Kathy Blanke Journal: Spine (Phila Pa 1976) Date: 2003-09-15 Impact factor: 3.468
Authors: M Formica; E Quarto; A Zanirato; L Mosconi; M Lontaro-Baracchini; M Alessio-Mazzola; L Felli Journal: Eur Spine J Date: 2020-09-15 Impact factor: 3.134
Authors: Jake M McDonnell; Shane R Evans; Daniel P Ahern; Gráinne Cunniffe; Christopher Kepler; Alexander Vaccaro; Ian D Kaye; Patrick B Morrissey; Scott C Wagner; Arjun Sebastian; Joseph S Butler Journal: Eur Spine J Date: 2022-09-30 Impact factor: 2.721