Name of the Procedure:

Osteotomy of the Spine, Posterior or Posterolateral Approach, 3 Columns, 1 Vertebral Segment (e.g., Pedicle/Vertebral Body Subtraction); Lumbar

Summary

An osteotomy of the spine is a surgical procedure where a portion of a vertebra in the lower back (lumbar region) is cut and realigned. This particular procedure involves accessing the spine from the back (posterior or posterolateral approach) and focusing on three vertebral columns at one segment.

Purpose

This procedure is primarily used to correct spinal deformities such as kyphosis or scoliosis. The goal is to realign the spine to improve posture, reduce pain, and enhance the patient’s ability to move.

Indications

• Severe spinal deformities like kyphosis or scoliosis causing pain or mobility issues.
• Failed previous spinal surgeries.
• Progressive spinal misalignment that does not respond to conservative treatments.

Preparation

• Patients may need to fast for several hours before the surgery.
• Medication adjustments, such as stopping blood thinners.
• Preoperative imaging studies like X-rays, CT scans, or MRIs.
• Comprehensive pre-surgery assessments.

Procedure Description

1. Anesthesia: Patient is placed under general anesthesia.
2. Incision: A surgical cut is made in the back to access the lumbar spine.
3. Exposure: Muscles and tissues are carefully retracted to expose the vertebrae.
4. Osteotomy: A cut is made in a vertebra to remove a wedge-shaped section, realigning the spine.
5. Realignment and Fixation: The spine is realigned, and hardware such as screws and rods is used to maintain the new position.
6. Closure: The incision is closed with sutures.

Duration

The procedure typically takes 4 to 6 hours.

Setting

Usually performed in a hospital's operating room.

Personnel

• Orthopedic surgeon or neurosurgeon
• Surgical nurses
• Anesthesiologist
• Surgical technologist

Risks and Complications

• Infection
• Blood loss
• Nerve damage
• Blood clots
• Spinal fluid leak
• Failure to achieve the desired spinal alignment

Benefits

• Improved spinal alignment
• Reduced pain
• Enhanced mobility and function Patients may start realizing benefits within weeks to months after surgery.

Recovery

• Hospital stay for a few days post-surgery.
• Pain management using medications.
• Physical therapy to aid recovery.
• Restrictions on heavy lifting and certain activities for several months.
• Follow-up appointments for monitoring progress.

Alternatives

• Non-surgical treatments like physical therapy, bracing, or pain management.
• Other types of spinal surgeries such as spinal fusion or laminectomy.
• Alternatives may offer shorter recovery times but may not be as effective for severe deformities.

Patient Experience

• Expect significant discomfort and limited mobility immediately after the surgery.
• Pain managed with medications and gradual improvement as recovery progresses.
• Physical therapy plays a crucial role in regaining strength and mobility.