الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Reestablishment of sagittal alignment in patients with fixed sagittal deformity is a critical step in optimizing function and decreasing pain in patients undergoing spinal reconstruction. We can calculate the number of degrees of correction needed to return sagittal balance from a fixed point in the spine. This calculation establishes the size and shape parameters of a pedicle subtraction osteotomy that will restore spinal balance. Moreover, the technique and power of pedicle subtraction osteotomy lends itself to a precision cut technique for balancing the sagittal plane. This is particularly important in patients undergoing fusion from the structural thoracic spine to the sacrum. These patients lose much of their normal compensatory mechanisms and are dependent on final surgical positioning to achieve spinal sagittal balance. Most of the patients maintained good correction and had good clinical results. Based on the results of this study, pedicle subtraction osteotomy is effective for correction of the kyphotic deformity in ankylosing spondylitis.
Patient satisfaction was high in this group of patients at greater than 2-year follow-up, with improved pain scale and Oswestry scores. The best surgical procedure for a given patient can be determined, considering the global spino-pelvic sagittal balance and the individual morphological variations. Although the initial reports of this procedure were for nontraumatic conditions, we have found this approach to be highly effective in correcting chronic posttraumatic kyphotic deformity.