Pelvic Osteotomy for Spinal Deformities

Abstract

Much like lower limb axes are important in the planning and correction of limb deformity, sagittal spinal alignment parameters are key in the assessment and treatment of spinal deformity. They include the standard sagittal spinal alignment parameters (thoracic kyphosis and lumbar lordosis), sagittal sacropelvic alignment (pelvic incidence, pelvic tilt, and sacral slope), and global sagittal balance parameters such as the C7 plumb line, spinal sacral angle, and spinal tilt. In patients with an abnormal sagittal spinal alignment, vertebral osteotomies such as pedicle subtraction osteotomies and fusion can be employed to correct the alignment. However, this can be technically very demanding, be prone to significant neurologic complications, and decrease spinal mobility. Alternatively, pelvic osteotomies can also be used to restore sagittal alignment, thus preserving lumbar mobility and positively impacting the patient’s quality of life and function.