• Keith H Bridwell.
• Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO 63110, USA. bridwellk@wudosis.wustl.edu
• Spine. 2006 Sep 1; 31 (19 Suppl): S171-8.

Study DesignAuthor experience and literature review.ObjectivesTo investigate and discuss decision-making on when to perform a Smith-Petersen osteotomy as opposed to a pedicle subtraction procedure and/or a vertebral column resection.Summary Of Background DataArticles have been published regarding Smith-Petersen osteotomies, pedicle subtraction procedures, and vertebral column resections. Expectations and complications have been reviewed. However, decision-making regarding which of the 3 procedures is most useful for a particular spinal deformity case is not clearly investigated.MethodsDiscussed in this manuscript is the author's experience and the literature regarding the operative options for a fixed coronal or sagittal deformity.ResultsThere are roles for Smith-Petersen osteotomy, pedicle subtraction, and vertebral column resection. Each has specific applications and potential complications.ConclusionAs the magnitude of resection increases, the ability to correct deformity improves, but also the risk of complication increases. Therein, an understanding of potential applications and complications is helpful.

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