Minimally Invasive Pedicle Subtraction Osteotomy.

For patients with significant spinal deformity, the pedicle subtraction osteotomy provides a powerful means for correction, albeit with high morbidity. With the trend toward minimally invasive spine surgery, multiple less invasive techniques have been devised; however, there seems to be an upper limit to the degree of correction possible. The mini-open pedicle subtraction osteotomy addresses these limitations by minimizing the extent of soft tissue destruction needed to perform the osteotomy and by using the rod-cantilever technique to achieve maximum lordosis. Preliminary data are promising, with significant improvements in patient-reported clinical outcome measures as well as coronal and sagittal alignment.