From the Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (Sivaganesan); Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Kim).
J Am Acad Orthop Surg. 2022 Feb 1;30(3):e295-e300. doi: 10.5435/JAAOS-D-21-00177.
Cervical spine deformity is a debilitating condition that can be challenging to treat. For patients with fixed, focal, kyphotic deformities near the cervicothoracic junction, a pedicle subtraction osteotomy (PSO) can be considered. Classifying a given cervical spine deformity and quantifying the mismatch between current and desired alignment are critical steps in determining whether a PSO should be done. It is also important to understand the relative contraindications for a cervical PSO and the radiographic and patient-reported outcomes associated with the procedure. Here, we review these topics and the details of our surgical technique and postoperative considerations. Specific nuances of the setup, exposure/approach, osteotomy, closure, and postoperative protocol are highlighted. A surgical video is also included (Video 1). Our aim is to provide a conceptual framework for understanding when a cervical PSO should be considered, how it can be performed effectively, and the outcomes that can be expected.
颈椎畸形是一种使人虚弱的病症，治疗起来具有挑战性。对于颈椎与胸交界处存在固定、局灶性、后凸畸形的患者，可以考虑行脊柱椎弓根切除截骨术（PSO）。对特定的颈椎畸形进行分类，并定量评估当前和期望的对线之间的不匹配，是决定是否行 PSO 的关键步骤。了解颈椎 PSO 的相对禁忌证以及与该手术相关的影像学和患者报告结果也很重要。在这里，我们回顾了这些主题以及我们的手术技术和术后注意事项的细节。强调了设置、暴露/入路、截骨、闭合和术后方案的具体细节。还包括一个手术视频（视频 1）。我们的目的是提供一个概念框架，以了解何时应考虑行颈椎 PSO，如何有效地进行该手术，以及可以预期的结果。
