The Use of Sacral Osteotomy in the Correction of Spinal Deformity: Technical Report and Systematic Review of the Literature

Zach Pennington, A. Karim Ahmed, C. Rory Goodwin, Erick M. Westbroek, Daniel Sciubba

Research output: Contribution to journalArticle

Abstract

Background: Flat back deformity is a disabling adverse outcome following instrumented lumbar fusion. As patients are often fused in this non-physiologic alignment, correction is complex and has conventionally required fracture of the preexisting fusion mass. Sacral osteotomy may be one effective means of correcting the positive sagittal balance in these patients. Here we report a case of flat back deformity corrected using a 3-column sacral osteotomy, and systematically review the available literature on the effectiveness of 3-column sacral osteotomy for correcting flat back deformity. Methods: A systematic review was performed using the results of a search of the PubMed, EMBASE, Web of Science, and Cochrane databases according to PRISMA guidelines. We also include our patient as an example of the technique. Results: Eight studies–all case reports or small case series–were identified describing 37 patients, including our case example. The variety of techniques was too heterogeneous for meta-analysis, but all studies reported good correction of sagittal deformity. Transient L5 palsy was the most common side effect of this technique, being reported in 21 patients (56.8%) across all studies. Conclusions: Sacral osteotomy is potentially an effective means of correcting positive sagittal balance in patients with flat back deformity secondary to high pelvic incidence.

Original languageEnglish (US)
Pages (from-to)285-292
Number of pages8
JournalWorld neurosurgery
Volume130
DOIs
StatePublished - Oct 1 2019

Fingerprint

Osteotomy
PubMed
Paralysis
Meta-Analysis
Databases
Guidelines
Incidence

Keywords

  • 3-column osteotomy
  • Failed back syndrome
  • Flat back syndrome
  • Osteotomy
  • Spinopelvic deformity

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

The Use of Sacral Osteotomy in the Correction of Spinal Deformity : Technical Report and Systematic Review of the Literature. / Pennington, Zach; Ahmed, A. Karim; Goodwin, C. Rory; Westbroek, Erick M.; Sciubba, Daniel.

In: World neurosurgery, Vol. 130, 01.10.2019, p. 285-292.

Research output: Contribution to journalArticle

Pennington, Zach ; Ahmed, A. Karim ; Goodwin, C. Rory ; Westbroek, Erick M. ; Sciubba, Daniel. / The Use of Sacral Osteotomy in the Correction of Spinal Deformity : Technical Report and Systematic Review of the Literature. In: World neurosurgery. 2019 ; Vol. 130. pp. 285-292.
@article{8f4f0071b2cf43ca9db806c8b75148fe,
title = "The Use of Sacral Osteotomy in the Correction of Spinal Deformity: Technical Report and Systematic Review of the Literature",
abstract = "Background: Flat back deformity is a disabling adverse outcome following instrumented lumbar fusion. As patients are often fused in this non-physiologic alignment, correction is complex and has conventionally required fracture of the preexisting fusion mass. Sacral osteotomy may be one effective means of correcting the positive sagittal balance in these patients. Here we report a case of flat back deformity corrected using a 3-column sacral osteotomy, and systematically review the available literature on the effectiveness of 3-column sacral osteotomy for correcting flat back deformity. Methods: A systematic review was performed using the results of a search of the PubMed, EMBASE, Web of Science, and Cochrane databases according to PRISMA guidelines. We also include our patient as an example of the technique. Results: Eight studies–all case reports or small case series–were identified describing 37 patients, including our case example. The variety of techniques was too heterogeneous for meta-analysis, but all studies reported good correction of sagittal deformity. Transient L5 palsy was the most common side effect of this technique, being reported in 21 patients (56.8{\%}) across all studies. Conclusions: Sacral osteotomy is potentially an effective means of correcting positive sagittal balance in patients with flat back deformity secondary to high pelvic incidence.",
keywords = "3-column osteotomy, Failed back syndrome, Flat back syndrome, Osteotomy, Spinopelvic deformity",
author = "Zach Pennington and Ahmed, {A. Karim} and Goodwin, {C. Rory} and Westbroek, {Erick M.} and Daniel Sciubba",
year = "2019",
month = "10",
day = "1",
doi = "10.1016/j.wneu.2019.07.083",
language = "English (US)",
volume = "130",
pages = "285--292",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - The Use of Sacral Osteotomy in the Correction of Spinal Deformity

T2 - Technical Report and Systematic Review of the Literature

AU - Pennington, Zach

AU - Ahmed, A. Karim

AU - Goodwin, C. Rory

AU - Westbroek, Erick M.

AU - Sciubba, Daniel

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: Flat back deformity is a disabling adverse outcome following instrumented lumbar fusion. As patients are often fused in this non-physiologic alignment, correction is complex and has conventionally required fracture of the preexisting fusion mass. Sacral osteotomy may be one effective means of correcting the positive sagittal balance in these patients. Here we report a case of flat back deformity corrected using a 3-column sacral osteotomy, and systematically review the available literature on the effectiveness of 3-column sacral osteotomy for correcting flat back deformity. Methods: A systematic review was performed using the results of a search of the PubMed, EMBASE, Web of Science, and Cochrane databases according to PRISMA guidelines. We also include our patient as an example of the technique. Results: Eight studies–all case reports or small case series–were identified describing 37 patients, including our case example. The variety of techniques was too heterogeneous for meta-analysis, but all studies reported good correction of sagittal deformity. Transient L5 palsy was the most common side effect of this technique, being reported in 21 patients (56.8%) across all studies. Conclusions: Sacral osteotomy is potentially an effective means of correcting positive sagittal balance in patients with flat back deformity secondary to high pelvic incidence.

AB - Background: Flat back deformity is a disabling adverse outcome following instrumented lumbar fusion. As patients are often fused in this non-physiologic alignment, correction is complex and has conventionally required fracture of the preexisting fusion mass. Sacral osteotomy may be one effective means of correcting the positive sagittal balance in these patients. Here we report a case of flat back deformity corrected using a 3-column sacral osteotomy, and systematically review the available literature on the effectiveness of 3-column sacral osteotomy for correcting flat back deformity. Methods: A systematic review was performed using the results of a search of the PubMed, EMBASE, Web of Science, and Cochrane databases according to PRISMA guidelines. We also include our patient as an example of the technique. Results: Eight studies–all case reports or small case series–were identified describing 37 patients, including our case example. The variety of techniques was too heterogeneous for meta-analysis, but all studies reported good correction of sagittal deformity. Transient L5 palsy was the most common side effect of this technique, being reported in 21 patients (56.8%) across all studies. Conclusions: Sacral osteotomy is potentially an effective means of correcting positive sagittal balance in patients with flat back deformity secondary to high pelvic incidence.

KW - 3-column osteotomy

KW - Failed back syndrome

KW - Flat back syndrome

KW - Osteotomy

KW - Spinopelvic deformity

UR - http://www.scopus.com/inward/record.url?scp=85072945013&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072945013&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2019.07.083

DO - 10.1016/j.wneu.2019.07.083

M3 - Article

C2 - 31323414

AN - SCOPUS:85072945013

VL - 130

SP - 285

EP - 292

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -