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Osteotomies/spinal column resection in paediatric deformity

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Abstract

The spinal deformities in paediatric population differ from those in the adult population. Vertebral osteotomies are indicated when the deformity is too rigid to be corrected either with instrumentation alone or with the addition of soft tissue releases. When surgical intervention is to be carried out, correcting the deformity and ceasing progression should be aimed at as well as allowing further growth and improving pulmonary function. Osteotomies in the spine surgery should aim to achieve an appropriate balance in both sagittal and coronal planes. Varied clinical and radiological scenarios necessitate different osteotomy types. The purpose of this article is to introduce each osteotomy type and discuss their indications, prerequisites and complications. Osteotomy options for correcting spinal deformities are Ponte osteotomy, Smith-Petersen osteotomy, pedicle subtraction osteotomy, bone-disc-bone osteotomy and vertebral column resection. All the osteotomy types are technically demanding. Appropriate selection of the type of the osteotomy depends on the surgeons’ experience, type of the deformity, magnitude of the curve, remaining growth potential and operative goals. Neuromonitoring should be an indispensible part of the procedure. Spine osteotomies are effective procedures for the treatment of paediatric spine deformities if experienced surgical team performs them.

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Conflict of interest

Dr. Gokcen and Dr. Yilgor have nothing to disclose. Dr. Alanay is a consultant and receives research grant from DePuy & Synthes.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey

    Bahadir Gokcen

  2. Department of Orthopaedics and Traumatology, Kiziltepe State Hospital, Mardın, Turkey

    Caglar Yilgor

  3. Acibadem Maslak Hospital Comprehensive Spine Center, Acibadem University School of Medicine, Department of Orthopaedics and Traumatology, Büyükdere Cad. No: 40, Maslak, 34457, Istanbul, Turkey

    Ahmet Alanay

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  1. Bahadir Gokcen
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  2. Caglar Yilgor
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  3. Ahmet Alanay
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Correspondence to Ahmet Alanay.

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Gokcen, B., Yilgor, C. & Alanay, A. Osteotomies/spinal column resection in paediatric deformity. Eur J Orthop Surg Traumatol 24 (Suppl 1), 59–68 (2014). https://doi.org/10.1007/s00590-014-1477-1

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  • DOI: https://doi.org/10.1007/s00590-014-1477-1

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