What is Spinal Osteotomy?

Spinal osteotomy is a surgical procedure used to treat significant spinal deformity, sometimes as part of a spinal reconstruction. During spinal osteotomy, one or more pieces of bone are removed. This creates a curve, allowing for proper realignment of the spine.

There are three major types of spinal osteotomy. In order of amount of bone removed, they are:

  • Smith-Peterson osteotomy or SPO, which offers a small amount of correction and is often performed on multiple levels of the spine. This procedure is the least invasive, removing a small piece of bone from the back of the vertebra.
  • Pedicle subtraction osteotomy or PSO, which is often used in the lower back for the treatment of flatback syndrome, a condition in which the lower spine loses its natural curve. A slice or wedge of bone going through the entire vertebral column is removed, allowing more movement for repositioning.
  • Vertebral column resection or VCR, which is the most involved spinal osteotomy surgery. It is almost always performed as part of a spinal reconstruction. One or more entire vertebrae are removed, and the spine is fused into place with rods or screws.

After surgery, it is common to stay in the hospital for several days. Recovery can be slow, and you will likely need help doing regular activities for the first few weeks. Lifting objects and bending or twisting, such as when getting out of bed or into a car, will be extremely difficult at first. Physical therapy can help you heal and move. Most daily activities can be resumed after six weeks, and most patients return to full activity, including playing certain sports, within a year.

Although the recovery from spinal osteotomy can be significant, it can be quite effective at reducing pain. Correcting a spinal deformity can also improve appearance and self-esteem, increase balance, and improve stability when moving.

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