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Year : 1978  |  Volume : 12  |  Issue : 1  |  Page : 42-49

Vertebral Osteotomy For Kyphosis


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P. S Saxena


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Wedge osteotomy of spine, a one stage operation was first described by Smith Peterson and his associates (1945) for flexion deformity of spine Marie Strumpell’s arthritis. Since then, a number of reports have been published with some modification in the mode of anesthesia, the position of the patients on the operation table and the operative procedure. La Chapelle (1946) advocated a two stage operation; a wedge osteotomy from posterior approach, followed by a division of the anterior longitudinal ligament through an anterior approach at the second stage. Wilson (1949) mentioned multiple wedge osteotomy. Law (1949) and Adams (1952) preferred to fuse the osteotomy site at the same time. However, a close review of the reports shows that the results of the subsequent workers were not significantly different from those of the original workers. Therefore, in this series, to start with, the procedure described by Smith Petersen, and his associates (1945), was adopted. But, follow up of the first 4 patients revealed that recurrence of the deformity occurred just above the level of osteotomy with on year or so, due to gradual diminution in the angle of correction and flexion of the spine above the osteotomy site. To void this, the spine could be fixed with a stainless steel rod or arthrodesed. Hence, it was decided to perform posterior fusion of the ‘vulnerable spine’ which included the osteotomy site and 4 to 5 vertebrae above it.


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