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Open access

Rebecca M. Burke, Thomas J. Buell, Dominic M. Maggio, Ulas Yener, Chun-Po Yen, Christopher I. Shaffrey, and Justin S. Smith

Adolescent idiopathic scoliosis patients treated with spinal fusion may develop adjacent segment disease and curve progression into adulthood. Revision operations can be challenging, especially for adult patients treated with outdated instrumentation such as sublaminar hooks and/or wires. The authors demonstrate revision lumbar spine surgery in a 38-year-old female with scoliosis progression from junctional degeneration below a prior T5–L3 posterior instrumented arthrodesis with a hook-and-rod wire system. They also demonstrate safe application of an ultrasonic bone scalpel for completion of a Smith-Petersen osteotomy. The patient provided written, informed consent for all material presented in this case demonstration.

The video can be found here: https://youtu.be/3PmaFtNcqKc.

Open access

Justin S. Smith, Christopher I. Shaffrey, Michael Wang, Mohamad Bydon, and Lawrence Lenke

Open access

Alexandria C. Marino, Thomas J. Buell, Rebecca M. Burke, Tony R. Wang, Chun-Po Yen, Christopher I. Shaffrey, and Justin S. Smith

Three-column osteotomies (3COs) can achieve significant alignment correction when revising fixed sagittal plane deformities; however, the technique is associated with high complication rates. The authors demonstrate staged anterior-posterior surgery with L5–S1 ALIF (below a prior L3–5 fusion) and multilevel Smith-Petersen osteotomies to circumvent the morbidity associated with 3CO. The patient was a 67-year-old male with three prior lumbar surgeries who presented with back and leg pain. Imaging demonstrated lumbar flat back deformity and sagittal imbalance. The narrated video details key radiological measurements, operative planning and rationale, surgical steps, and outcomes. The patient provided written, informed consent for publication of this illustrative case.

The video can be found here: https://youtu.be/wv4W9D9fUPc.