Quinonez Alejandro J, Carroll Austin H, Mo Fred
Orthopedic Surgery, Georgetown University School of Medicine, Washington DC, USA.
Orthopedic Surgery, MedStar Georgetown University Hospital, Washington DC, USA.
Cureus. 2024 Nov 12;16(11):e73534. doi: 10.7759/cureus.73534. eCollection 2024 Nov.
Pedicle subtraction osteotomy (PSO) is a technically complex procedure that is effective at improving the sagittal profile in spinal deformity surgery. This case report describes a 64-year-old man with a history of ten previous spinal surgeries, including failed T10-pelvis posterior spinal fusion, undergoing revision with L4 PSO. The patient regained approximately 30° of lumbar lordosis. The procedure was complicated by an uneventful intraoperative durotomy and delayed postoperative surgical site infection requiring two surgical debridements and a prolonged course of antibiotics. At the 14-month follow-up, the patient was ambulating 3 miles per day and had significantly decreased pain with no sign of recurrent infection. PSOs performed in revision cases are more challenging procedures but can achieve similar degrees of correction even in patients with multiple previous revisions.
椎弓根截骨术（PSO）是一种技术复杂的手术，在脊柱畸形手术中能有效改善矢状面外形。本病例报告描述了一名64岁男性，既往有10次脊柱手术史，包括T10-骨盆后路脊柱融合术失败，接受L4椎弓根截骨术翻修。患者恢复了约30°的腰椎前凸。该手术的并发症包括术中硬脊膜切开顺利、术后手术部位感染延迟，需要两次手术清创和延长抗生素疗程。在14个月的随访中，患者每天能行走3英里，疼痛明显减轻，无复发感染迹象。在翻修病例中进行的椎弓根截骨术是更具挑战性的手术，但即使在有多次既往翻修的患者中也能实现相似程度的矫正。
