What is Cervical and Lumbar Osteotomy for Deformity Correction?
You may be a candidate for a spinal osteotomy if you have a spinal deformity such as scoliosis or abnormal kyphosis. Cervical and lumbar spine osteotomies are surgical procedures that can be very helpful in treating spinal deformities. These types of surgeries correct spinal deformities to help patients relieve the pain they are having, restore the patient’s ability to function normally and improve a patient’s appearance.
What is Spine Osteotomy?
Spinal osteotomies are used to treat spinal abnormalities. They are also referred to as corrective spine osteotomies. The surgery typically requires the removal of a portion of spinal bone to correct spinal misalignment.
There are three places on the spine where it naturally curves:
- Cervical Lordosis: inward curve to the spine in the neck or the cervical spine
- Kyphosis: upper and mid-back curves in the spine or the thoracic spine
- Lumbar lordosis: inward curve to the lower back of the spine or the lumbar spine
These curves maintain the body’s stability and alignment over the pelvis. If any of these areas develop deformities or go out of place, a corrective spine osteotomies can help correct and reposition them.
Which Conditions Can Spinal Osteotomies Treat?
Spine osteotomies are prescribed for spinal deformities such as kyphosis greater than 70 degrees and scoliosis greater than 45 degrees.
A spinal deformity can result from a traumatic injury, neuromuscular disease, congenital disorders, or ankylosing spondylitis. Patients suffering from severe deformities may experience a loss of balance, stooping, exhaustion, pain, and difficulty moving the upper part of the body.
Symptoms of spinal abnormalities are greatly improved with a spine osteotomy. The benefits of corrective spine osteotomy include:
- Boost your energy and reduce fatigue
- Easier for someone to stand up
- Provides relief from pressure on the heart and lungs
- Stops the spinal deformity from worsening
Types of Spine Osteotomy
During a corrective spine osteotomy, a patient lies facedown on the operating table to give the surgeon access to the spine. Then, they go under a general anesthetic to stay relaxed during the procedure.
The surgeon will discuss the type of spinal osteotomy a patient will need, depending on the location and extent of the spinal deformity. For example, they may combine a spine osteotomy and spinal fusion with instrumentation to stabilize the spine and stop future curvature. Osteotomies fall into three categories:
Smith-Petersen osteotomy (SPO)
The surgeon can recommend this surgery if there are any mild defects in the spine. A spinal defect can be a deformity of 10-20 degrees per level in the spine. The operation involves cutting out a portion of the spine, slanting further backward. They also remove the facet joints and posterior ligaments from this region. This treatment does not use an anterior bone transplant because it requires moving through the front part of the spine or discs.
Pedicle subtraction osteotomy (PSO)
PSO is ideal for lumbar adjustments of about 30 degrees. A PSO affects the three spinal columns, the front, center, and back. An SPO entails removing the facet joints, vertebral body, and pedicles from the back. An advantage of PSO is that it permits more lordosis correction compared to an SPO.
Vertebral column resection osteotomy (VCR)
Going under a VCR means the surgeon takes out one or more vertebrae. This type of surgery allows for the most significant amount of adjustment in the spine. Because VCR creates a significant spinal deficit, these levels are also fused for reconstruction. Using a bone graft tissue or a metal cage during spinal fusion is possible. The original VCR involved going through the spine’s front and back. Nowadays, surgeons operate through the back only when using a VCR.
The surgeon will close the incision after performing a spinal osteotomy. A solid bone forms as the bone graft fuses with the vertebrae. The success of bone fusion is fundamental to the health and stability of the spine.
Recovery from a Cervical and Lumbar Osteotomy
Patients can take medication to treat post-surgical discomfort. In addition, the surgeon may prescribe a collar in certain circumstances, especially if it is a cervical osteotomy.
Discuss with your doctor the appropriate time to walk and exercising usually. X-rays may be required to determine whether the bone has fused successfully during the healing process.
You can have some reduced mobility after a spinal fusion. You need to consider your specific surgery, however. Physiotherapy will aid your rehabilitation, and you should listen to your doctor about when vigorous or strenuous activities are safe.
Find Out If You Need a Spinal Osteotomy
A spinal osteotomy can provide the back relief you need to enjoy regular activities and live a healthier life. It also provides stability to your spine without endangering your internal organs. However, when treating scoliosis or any complex spinal deformity, it’s crucial that you consult with an experienced spinal surgeon. To schedule an appointment with Dr. Butler, complete our contact form.