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Ponte osteotomies in thoracic deformities

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Abstract

Thoracic hyperkyphosis is a sagittal deformity that can cause back pain and neurological impairment, leading to difficulties in maintaining a straight gaze. Sagittal thoracic malalignment has different etiologies and different corrective strategies. An adequate preoperative planning is mandatory to address correctly the surgical treatment, using an appropriate sagittal deformities classification and the rules that relate pelvic parameters to spine curvatures to determine the correction needed to restore a good sagittal alignment. Ponte osteotomies are performed in long non-angular hyperkyphotic thoracic deformities, even if idiopathic scoliosis, rigid deformities or proximal junctional kyphosis after instrumented fusions can benefit from the application of this technique that requires a mobile anterior column for the correction of the deformity. Ponte’s is, together with Smith-Petersen osteotomy, a posterior column osteotomy. The magnitude of correction can reach 10° per level if intervertebral discs are still mobile.

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References

  1. De Jonge T, Illes T, Bellyei A (2001) Surgical correction of Scheuermann kyphosis. Int Orthop 25(2):70–73

    Article  PubMed Central  PubMed  Google Scholar 

  2. Scheuermann HW (1920) Kyphosis dorsalis juvenilis. Ugeskr Laeger 82:385–393

    Google Scholar 

  3. Lichtblau PO, Wilson PD (1956) Possible mechanism of aortic rupture in orthopaedic correction of rheumatoid spondylitis. J Bone Joint Surg Am 38-A(1):123–127

    CAS  PubMed  Google Scholar 

  4. Kim KT, Suk KS, Cho YJ, Hong GP, Park BJ (2002) Clinical outcome results of pedicle subtraction osteotomy in ankylosing spondylitis with kyphotic deformity. Spine (Phila Pa 1976) 27(6):612–618

    Article  Google Scholar 

  5. Bridwell KH (2006) Decision making regarding Smith-Petersen vs. pedicle substraction osteotomy vs. vertebral column resection for spinal deformity. Spine (Phila Pa 1976) 31 Suppl(19):S171–S178

    Article  Google Scholar 

  6. Pellisé F, Vila-Casademunt A (2014) Posterior thoracic osteotomies. Eur J Orthop Surg Traumatol 24(Suppl 1):S39–S48

    Article  PubMed  Google Scholar 

  7. Cho KJ, Lenke LG, Bridwell KH et al (2009) Selection of the optimal distal fusion level in posterior instrumentation and fusion for thoracic hyperkyphosis: the sagittal stable vertebra concept. Spine (Phila Pa 1976) 34:765–770

    Article  Google Scholar 

  8. Ponte A, Vero B, Siccardi GL (1984) Surgical treatment of Scheuermann’s kyphosis. In: Winter RB (ed) Progress in spinal pathology: kyphosis. Aulo Gaggi, Bologna, pp 75–80

    Google Scholar 

  9. Dorward IG, Lenke LG, Stoker GE, Cho W, Koester LA, Sides BA (2014) Radiographic and clinical outcomes of posterior column osteotomies in spinal deformity correction. Spine (Phila Pa 1976) (Epub ahead of print)

  10. Gokcen B, Yilgor C, Alanay A (2014) Osteotomies/spinal column resection in paediatric deformity. Eur J Orthop Surg Traumatol 24(Suppl 1):S59–S68

    Article  PubMed  Google Scholar 

  11. Lewis SJ, Goldstein S, Bodrogi A, Dear T, Keshen SGN, Shihata S, Lewis NDH, Magana S (2014) Comparison of pedicle subtraction and Smith-Petersen osteotomies in correcting thoracic kyphosis when closed with a central hook-rod construct. Spine (Phila Pa 1976) 39(15):1217–1224

    Article  Google Scholar 

  12. Cho KJ, Bridwell KH, Lenke LG, Berra A, Baldus C (2005) Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance. Spine (Phila Pa 1976) 30(18):2030–7

  13. Iorio J, Bennett JT, Orlando G, Singla A, Dakwar E, Bonet H, Samdani AF (2013) Does Amicar affect blood loss in patients with adolescent idiopathic scoliosis treated with pedicle screws and Ponte osteotomies? Surg Technol Int 23:291–295

    PubMed  Google Scholar 

  14. Smith JS, Sansur CA, Donaldson WF 3rd, Perra JH, Mudiyam R, Choma TJ, Zeller RD, Knapp DR Jr, Noordeen HH, Berven SH, Goytan MJ, Boachie-Adjei O, Shaffrey CI (2011) Short-term morbidity and mortality associated with correction of thoracolumbar fixed sagittal plane deformity: a report from the Scoliosis Research Society Morbidity and Mortality Committee. Spine (Phila Pa 1976) 36(12):958–964

    Article  Google Scholar 

  15. Kim KT, Jo DJ, Lee SH, Park KJ, Sin JH (2012) Does it need to perform anterior column support after Smith-Petersen osteotomy for ankylosing spondylitis? Eur Spine J 21(5):985–991

    Article  PubMed Central  PubMed  Google Scholar 

  16. Bradford DS, Schumacher WL, Lonstein JE, Winter RB (1987) Ankylosing spondylitis: experience in surgical management of 21 patients. Spine (Phila Pa 1976) 12(3):238–243

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Chief Spine Unit, Orthopaedic Department, Hospital La Paz, Madrid, Spain

    F. Sánchez Pérez-Grueso

  2. 2nd Spine Surgery Division, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    Riccardo Cecchinato

  3. 4th Spine Surgery Division, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    Pedro Berjano

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  1. F. Sánchez Pérez-Grueso
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  2. Riccardo Cecchinato
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  3. Pedro Berjano
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Correspondence to F. Sánchez Pérez-Grueso.

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Pérez-Grueso, F.S., Cecchinato, R. & Berjano, P. Ponte osteotomies in thoracic deformities. Eur Spine J 24 (Suppl 1), 38–41 (2015). https://doi.org/10.1007/s00586-014-3617-z

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  • DOI: https://doi.org/10.1007/s00586-014-3617-z

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