Revision thoracolumbar surgery for flat back deformity: staged ALIF and posterior column osteotomies to avoid three-column osteotomy.

Abstract

Three-column osteotomies (3COs) can achieve significant alignment correction when revising fixed sagittal plane deformities; however, the technique is associated with high complication rates. The authors demonstrate staged anterior-posterior surgery with L5-S1 ALIF (below a prior L3-5 fusion) and multilevel Smith-Petersen osteotomies to circumvent the morbidity associated with 3CO. The patient was a 67-year-old male with three prior lumbar surgeries who presented with back and leg pain. Imaging demonstrated lumbar flat back deformity and sagittal imbalance. The narrated video details key radiological measurements, operative planning and rationale, surgical steps, and outcomes. The patient provided written, informed consent for publication of this illustrative case. The video can be found here: https://youtu.be/wv4W9D9fUPc.

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Citation

Published Version (Please cite this version)

10.3171/2020.1.focusvid.19740

Publication Info

Marino, Alexandria C, Thomas J Buell, Rebecca M Burke, Tony R Wang, Chun-Po Yen, Christopher I Shaffrey and Justin S Smith (2020). Revision thoracolumbar surgery for flat back deformity: staged ALIF and posterior column osteotomies to avoid three-column osteotomy. Neurosurgical focus: Video, 2(1). p. V5. 10.3171/2020.1.focusvid.19740 Retrieved from https://hdl.handle.net/10161/28171.

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Shaffrey

Christopher Ignatius Shaffrey

Professor of Orthopaedic Surgery

I have more than 25 years of experience treating patients of all ages with spinal disorders. I have had an interest in the management of spinal disorders since starting my medical education. I performed residencies in both orthopaedic surgery and neurosurgery to gain a comprehensive understanding of the entire range of spinal disorders. My goal has been to find innovative ways to manage the range of spinal conditions, straightforward to complex. I have a focus on managing patients with complex spinal disorders. My patient evaluation and management philosophy is to provide engaged, compassionate care that focuses on providing the simplest and least aggressive treatment option for a particular condition. In many cases, non-operative treatment options exist to improve a patient’s symptoms. I have been actively engaged in clinical research to find the best ways to manage spinal disorders in order to achieve better results with fewer complications.


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