• Sanghyun Han, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim, Byoung Hun Lee, and Ho Yong Choi.
• Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
• World Neurosurg. 2017 Nov 1; 107: 839-845.

BackgroundPosterior column osteotomy (PCO) has been used for the correction of various spinal deformities. However, little evidence is available regarding the effects of multilevel PCO in adult spinal deformity (ASD) surgery. This study aimed to show the usefulness of PCO in rigid ASD surgery by assessing radiographic and clinical outcomes. We also aimed to assess the corrective potential of multilevel PCOs compared with a single-level pedicle subtraction osteotomy (PSO).MethodsBetween 2012 and 2016, the medical records of 70 consecutive patients who underwent a multilevel PCO (35 patients) or a single-level PSO (35 patients) for ASD in a single institute were reviewed. Baseline data, radiographic measurements, and clinical outcomes using the Scoliosis Research Society-22 (SRS-22) questionnaire were compared between groups.ResultsThe following variables were no different between the groups: age at surgery, sex, level fused, preoperative and postoperative radiologic parameters, and bone mineral density T score. However, operation time (380.0 vs. 483.6 minutes), estimated blood loss (1175.7 vs. 1362.6 mL), and the number of complications (8 vs. 20) were significantly reduced in the PCO group compared with the PSO group. A significant improvement in the SRS-22 score was seen in both groups after surgery, although no difference was observed between the groups postoperatively.ConclusionsMultilevel PCOs for the correction of rigid ASD were slightly superior to PSO, regarding clinical outcomes. Radiographic outcomes were similar between groups. Thus, multilevel PCOs may be a viable option for the treatment of rigid ASD with a mobile segment.Copyright © 2017 Elsevier Inc. All rights reserved.

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