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Neurosurg Clin N Am. 2018 Jul;29(3):341-354. doi: 10.1016/j.nec.2018.03.004.

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

Author information

1
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue M779, San Francisco, CA 94143, USA. Electronic address: Andrew.chan@ucsf.edu.
2
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue M779, San Francisco, CA 94143, USA.
3
Department of Neurosurgery, University of Virginia, PO Box 800386, Charlottesville, VA 22908, USA.

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.

KEYWORDS:

Anterior lumbar interbody fusion; Lumbar lordosis; Pedicle subtraction osteotomy; Sagittal imbalance

PMID:
29933802
DOI:
10.1016/j.nec.2018.03.004
[Indexed for MEDLINE]

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