Spinal Osteotomy
A spinal osteotomy is a powerful and highly specialized surgical technique used during complex spinal reconstruction surgery. The term literally means 'cutting of bone' (from Greek 'osteon' for bone and 'tome' for cut). It is performed to correct severe, rigid spinal deformities that cannot be realigned with standard instrumentation alone. By strategically removing a section of a vertebra, the surgeon essentially creates a hinge or a gap in the stiff spinal column. This 'unlocks' the spine, allowing it to be moved into a more natural and balanced alignment. It is a cornerstone of modern deformity surgery for conditions like severe kyphosis ('hunchback') and fixed sagittal imbalance.
Spinal osteotomies are graded by their corrective power. The simplest is the Smith-Petersen Osteotomy (SPO), which involves removing posterior bone for a modest correction. A more powerful technique is the Pedicle Subtraction Osteotomy (PSO), where a wedge of bone is removed from a single vertebra to achieve a large, angular correction of 30-40 degrees. The most radical procedure is the Vertebral Column Resection (VCR), which involves removing an entire vertebra to correct the most severe spinal deformities.
A spinal osteotomy is a critical step within a larger fusion surgery where bone is cut to allow for the realignment of a rigid deformity. Using screws and rods, the surgeon closes the osteotomy gap to correct the spine's alignment before adding a bone graft. This is a high-stakes procedure with a significant risk of neurological injury due to the proximity of the spinal cord. To ensure safety, surgeons rely on essential technologies like intraoperative neuromonitoring to track nerve function in real-time and surgical navigation to guide the bone cuts with precision.
Spinal osteotomy is a transformative technique that enables skilled surgeons to correct the most challenging fixed spinal deformities, restoring balance and allowing patients to stand upright. While the procedure is complex and the risks are significant, the meticulous planning and use of essential safety technologies in the hands of an experienced spinal deformity surgeon make it a predictable and life-altering surgery for patients with no other options for correction.