Lamina-preserving, Type II Posterior Column Osteotomies (PCOs) for Correction of Adult (Thoraco) Lumbar Scoliosis.

Abstract

Operative video and supplemental manuscript. To present a step-by-step approach to performing lamina-preserving lumbar posterior column osteotomies (PCO) for correction of adult thoracolumbar scoliosis. Outcomes of operations for adult thoracolumbar spinal deformities are dictated by adequate neural decompression, restoration of appropriate alignment, and achievement of fusion. A surgical strategy that optimizes attainment of all 3 of these goals is important to understand. A step-by-step approach to performing lamina-preserving lumbar PCOs is provided through a case example and surgical technique video, Supplemental Digital Content 1, http://links.lww.com/CLINSPINE/A393. Lamina-preserving PCOs performed at multiple levels are a particularly useful surgical strategy to correct adult thoracolumbar scoliosis, as they provide significant mobilization of the spine and allow for wide decompression of neural elements centrally and in the lateral recess and foramen while maintaining significant central osseous surfaces for interlaminar fusion. Multilevel lamina-preserving PCOs allow for excellent neural decompression, powerful restoration of appropriate sagittal and coronal spinal alignment through release of the lumbar spine, and facilitate interlaminar union, all of which are critical to optimal outcomes of operations for adult thoracolumbar scoliosis.