So your surgeon want to “cut” your spine….that just doesn’t
sound good, does it?
Well what are they talking about “cutting” the bone of your
spine? To surgeons it is call an “osteotomy” which, if you break the word down
to its latin roots, means bone (for “osteo”) and cutting part of the body (for
The first spine osteotomy was done by an Italian surgeon,
Alberto Ponte, in the mid-1970s for increased kyphosis or rounding of the
back. Dr. Ponte wanted to loosen the
spine to get better correction of spine deformity, so he removed bone and soft
tissue between vertebra, done all from the back side. Over the last 40+ years
these osteotomies have been used around the world for all types of spine
So how does your surgeon do these osteotomies?
STEP 1: The
goal is to completely remove all bone and soft tissues between the vertebra. So
the first step is to remove some bone (below shaded area) from the upper
STEP 2: Once
that is done the soft tissue in midline, call th
e ligamentum flavum (the vertical white tissue which looks like vertical blinds) is
the bone on the lower vertebra is removed….
This creates a complete gap between the vertebra (see below
picture at orange shaded area)
STEP 4: The
pedicle screws are then placed….and the spine is ready to be corrected to a
***So is this a safe procedure to do the spine? In the below research study we analyzed the
complications of doing spine osteotomies in pediatric and adolescent patients
at Washington University.
484 osteotomies in 142 patients were studied and there were
0.4% frequency of complications (2 patients had dural tears that were repaired
in surgery). So yes, these can be very
safe procedures to perform.
This is a good reference: