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Posterior thoracic osteotomies

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Abstract

Spinal osteotomies are used to treat partially flexible and fixed deformities. Fixed thoracic spinal deformities have been traditionally treated with anterior release and posterior correction with fusion. In recent decades, it has been shown that posterior-only osteotomies might be sufficient to achieve proper deformity correction with lower complication rates than with combined anterior and posterior procedures. Different types of osteotomies have been described to treat spinal deformities through a single posterior approach. These include posterior column osteotomies such as the Smith-Petersen osteotomy and the Ponte osteotomy, and three-column osteotomies such as the pedicle subtraction osteotomy, the posterior vertebral column resection and the posterior vertebral column decancellation. In general, three-column osteotomies are most commonly performed in the lumbar spine, where the vast majority of reports have focused on. They can also be performed in the thoracic spine in the setting of rigid thoracic deformity. A progressive increase in complications has been reported with more aggressive osteotomies. The aim of this article was to describe the most common posterior spinal osteotomies used to treat adult thoracic spinal deformities, with special emphasis on the technical aspects, complications and outcomes, based on current publications and European Spine Study Group (ESSG) data.

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Acknowledgments

We acknowledge DepuySynthes Spine for its funding support.

Conflict of interest

Dr. Pellisé reports grants from Depuy Synthes Spine, during the conduct of the study; grants and personal fees from Depuy Synthes Spine, grants from K2 M, personal fees from Biomet, outside the submitted work. Dr. Vila-Casademunt reports grants from Depuy Synthes Spine, during the conduct of the study; grants from Depuy Synthes Spine, outside the submitted work. Dr. (ESSG) reports grants from Depuy Synthes Spine, during the conduct of the study; grants from Depuy Synthes Spine, outside the submitted work.

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  1. Unitat de Raquis, servei de cirurgia ortopèdica i traumatologia, Hospital Universitari Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Ferran Pellisé

  2. Vall d’Hebron Institut de Recerca, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Alba Vila-Casademunt

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  1. Ferran Pellisé
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European Spine Study Group (ESSG)

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Correspondence to Ferran Pellisé.

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Pellisé, F., Vila-Casademunt, A. & European Spine Study Group (ESSG). Posterior thoracic osteotomies. Eur J Orthop Surg Traumatol 24 (Suppl 1), 39–48 (2014). https://doi.org/10.1007/s00590-014-1463-7

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  • DOI: https://doi.org/10.1007/s00590-014-1463-7

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