Pedicle Subtraction Osteotomy
Pedicle subtraction osteotomy (PSO) is a surgical procedure that can be used to help correct fixed sagittal plane deformities. These deformities may have a variety of etiologies, including degenerative, posttraumatic, neoplastic, infectious, metabolic, and congenital disorders [1-3]. The aging population and rising expectations for quality of life are leading to increasing numbers of patients seeking medical and surgical evaluation for symptomatic fixed sagittal deformity. With the advent of polysegmental three-column fixation with pedicle screws and advances in spinal instrumentation, posterior-only approaches for correcting kyphotic or kyphoscoliotic deformities have become feasible and more common in recent years, avoiding the need of anterior approaches [4]. The use of posterior-only osteotomies with pedicle screw instrumentation can provide significant alignment correction in all three dimensions, whereas greater pedicle screw pullout strength and stiffness limit the number of levels fused, allowing for preservation of more mobile spinal segment [4, 5].
