Pedicle Subtraction Osteotomy Steps, Procedure, Recovery Time, Complications

What is Pedicle Subtraction Osteotomy?

Pedicle Subtraction Osteotomy (PSO) is a surgical procedure used to correct severe spinal deformities such as kyphosis, which is an excessive forward curvature of the spine. The PSO involves removing a wedge-shaped section of bone from the posterior aspect of the vertebral body, including the pedicle, lamina, and facet joints.

The goal of PSO is to realign the spine to a more normal curvature, which can alleviate symptoms such as back pain, difficulty standing or walking, and breathing problems. The procedure is typically performed on patients with severe deformities that have not responded to non-surgical treatments, such as bracing or physical therapy.

Steps

The specific steps involved in a Pedicle Subtraction Osteotomy (PSO) procedure can vary depending on the individual patient's condition and the surgeon's approach. However, some general steps typically involved in a PSO procedure may include:

Pedicle Subtraction Osteotomy Steps, Procedure, Recovery Time, Complications

Anesthesia

The patient is given general anesthesia, which will make them unconscious and unable to feel pain during the surgery.

Incision

The surgeon makes a long incision down the center of the back, exposing the spine.

Exposure

The surgeon removes the muscles and tissues covering the spinal column, exposing the affected vertebrae.

Pedicle removal

The surgeon removes the pedicle, which is a small bony protrusion on the back of the vertebrae, using specialized instruments.

Osteotomy

The surgeon then makes a precise cut through the vertebral body to create a wedge-shaped piece of bone, which is then removed. This allows the surgeon to change the angle of the spine and reduce the deformity.

Rod placement

The surgeon places metal rods along the length of the spine, connecting the vertebrae above and below the osteotomy site.

Bone grafting

The surgeon fills the space created by the osteotomy with a bone graft, which helps to stabilize the spine.

Closure

The surgeon closes the incision with sutures or staples and applies bandages.

Procedure

Pedicle Subtraction Osteotomy (PSO) procedure involves making a long incision down the center of the back, removing the muscles and tissues covering the spine, and removing a wedge-shaped section of bone from the posterior aspect of the affected vertebrae. The surgeon then places metal rods along the length of the spine and fills the space created by the osteotomy with a bone graft. The incision is closed with sutures or staples, and the patient will typically spend several days in the hospital for monitoring and pain management, followed by a rehabilitation program to regain strength and mobility.

Recovery

Recovery from a Pedicle Subtraction Osteotomy (PSO) can be a lengthy process and may vary from patient to patient. Generally, the patient can expect the following during the recovery process:

Hospital stay

The patient will spend several days in the hospital for monitoring and pain management.

Immobilization

The patient will need to wear a brace or cast for several weeks to immobilize the spine and allow the bone graft to heal.

Rehabilitation

Physical therapy and rehabilitation exercises will be necessary to help the patient regain strength and mobility in the affected area.

Pain management

The patient may experience pain and discomfort, which can be managed with medications prescribed by the surgeon.

Follow-up appointments

The patient will need to have follow-up appointments with the surgeon to monitor progress and make any necessary adjustments to the treatment plan.

Complications

As with any surgical procedure, Pedicle Subtraction Osteotomy (PSO) carries some risks and potential complications. Some of the most common complications associated with PSO may include:

Infection

There is a risk of infection with any surgical procedure, and patients undergoing PSO may develop an infection in the wound or in the bone graft site.

Nerve damage

PSO may involve manipulation of the spinal nerves, which can lead to nerve damage, including numbness, weakness, or paralysis.

Blood loss

PSO is a complex procedure that may involve significant blood loss, which can lead to anemia, shock, or other complications.

Anesthesia complications

General anesthesia carries a risk of complications, including reactions to the anesthesia, breathing difficulties, and other complications.

Failure to correct the deformity

In some cases, PSO may not successfully correct the spinal deformity or may lead to complications that require further surgical intervention.

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