Approach Selection: Multiple Anterior Lumbar Interbody Fusion to Recreate Lumbar Lordosis Versus Pedicle Subtraction Osteotomy: When, Why, How?

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2018-07

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Abstract

Restoration of physiologic lumbar lordosis is a fundamental principle of spinal deformity surgery. Techniques using multilevel anterior lumbar interbody fusion or pedicle subtraction osteotomy (PSO) are described. Multilevel anterior lumbar interbody fusion provides a gradual multilevel correction and avoids the morbidity associated with PSO but necessitates familiarity with the anterior approach or an approach surgeon. PSO provides a large angular correction at a single level, requires only one approach, and allows for simultaneous multiplanar correction and open posterior decompression. This article provides guidance on the appropriate use of each technique for restoration of lumbar lordosis in patients with degenerative lumbar deformity.

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10.1016/j.nec.2018.03.004

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Chan, Andrew K, Praveen V Mummaneni and Christopher I Shaffrey (2018). Approach Selection: Multiple Anterior Lumbar Interbody Fusion to Recreate Lumbar Lordosis Versus Pedicle Subtraction Osteotomy: When, Why, How?. Neurosurgery clinics of North America, 29(3). pp. 341–354. 10.1016/j.nec.2018.03.004 Retrieved from https://hdl.handle.net/10161/17642.

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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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