July 5, 2017
In this video from the Open Operating Theatre, Rune Hedlund MD, from Sahlgrenska University Hospital in Gothenburg, Sweden, discusses how to perform a pedicle subtraction osteotomy to correct sagittal imbalance in a woman with degenerative scoliosis.
Surgery begins with an incision made from T10 to L5. The size of the screw is maximized in both length and diameter to improve fixation. Gel foam is used to control epidural bleeding and the lamina is cut to prevent compression of the geography while surgeons close the osteotomy. After osteotomy, a double-rod construct is used on the concave side because the alignment is off and it makes the surgery quicker. It also simplifies the surgery.