In this video from the Open Operating Theatre, Max Aebi, MD, DHC, FRCSC, from the department of orthopedic surgery at Salem-Spital in Switzerland, discusses how to perform three Smith-Peterson osteotomies to correct kyphoscoliosis.
The patient was placed in prone position with neuromonitoring. T10, T11 and T12 and L1 were exposed and the pedicles were opened. Pedicle screws were then inserted. L2, L3 and L4 were then exposed and the skin incision was extended to the sacrum. Screws were inserted into the iliac crest and L5 and were augmented with cement. The Smith-Peterson osteotomies were performed at T12-L1, L1-L2 and L4-L5. Pre-bent rods were connected to the screws step-by-step to achieve reduction. The screws were compressed against each other to create a tension bound construct to close the osteotomy wedges posteriorly. This aligned the spine in lordosis.
Fusion was achieved from T10 to the sacrum by covering the area with a mix of autologous bone and allogenic bone graft. A vertebroplasty was then performed into T9.
This video is intended as a teaching tool to help surgeons prepare for surgery or they can use it as a refresher on the surgical technique and indications for this surgery.