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J. Patrick Johnson, Robert S. Pashman, Carl Lauryssen, Neel Anand, John J. Regan and Robert S. Bray

osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am 85 : 454 – 463 , 2003 Bridwell KH, Lewis SJ, Lenke LG, Baldus C, Blanke K: Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am 85: 454–463, 2003 5. Bridwell KH , Lewis SJ , Rinella A , Lenke LG , Baldus C , Blanke K : Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. Surgical technique. J Bone Joint Surg Am 86 (Suppl 1) : S44 – S50 , 2004

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Benson P. Yang, Stephen L. Ondra, Larry A. Chen, Hee Soo Jung, Tyler R. Koski and Sean A. Salehi

ligament excision, and extensive osteotomies. Future investigators of pedicle subtraction osteotomy may choose to gather statistics specifically related to that portion of the operation. With experience, our thoracic PSOs have become much more efficient and our recent statistics are considerably improved. The early surgical and medical complications for lumbar and thoracic PSOs were similar and included premature termination of surgery, neurological injury, wound-related problems, and nosocomial infections. In contrast, the late complications were qualitatively

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Pedicle subtraction osteotomy in the treatment of chronic, posttraumatic kyphotic deformity Robert F. Heary Christopher M. Bono 7 2006 5 1 1 8 10.3171/spi.2006.5.1.1 SPI.2006.5.1.1 Clinical and radiographic outcomes of thoracic and lumbar pedicle subtraction osteotomy for fixed sagittal imbalance Benson P. Yang Stephen L. Ondra Larry A. Chen Hee Soo Jung Tyler R. Koski Sean A. Salehi 7 2006 5 1 9 17 10.3171/spi.2006.5.1.9 SPI.2006.5.1.9 Anterior stabilization of three-column thoracolumbar spinal trauma Rod J. Oskouian Jr. Christopher I. Shaffrey Richard

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Robert F. Heary and Christopher M. Bono

several forms. Conceptually, the procedure must be “lordogenic”—that is, it must produce lordosis. This can be achieved by lengthening the anterior elements, shortening the posterior elements, or a combination of the two. Pedicle subtraction osteotomy was developed to achieve significant deformity correction. In a single-stage, posterior-approach procedure, portions of the VB and posterior neural arch are resected. 2 , 5 , 14 , 24 Conceptually the procedure entails a shortening of the posterior elements but, in reality, it involves shortening of portions of the

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Minoru Ikenaga, Jitsuhiko Shikata, Mitsuru Takemoto and Chiaki Tanaka

S everal researchers have reported on the successful correction of thoracolumbar kyphosis using the vertebral osteotomy technique. 1 , 3–5 , 7 , 9 , 10 , 14–22 Although this technique is useful for correcting thoracolumbar kyphosis, various complications have been reported. 2 , 6 Pedicle subtraction osteotomy is a technically demanding procedure that requires surgeons to exercise caution to achieve satisfactory results while avoiding complications. To our knowledge, no previous studies have reported on the causes of complications after using the single

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Daisuke Togawa 4 2007 6 4 327 329 10.3171/spi.2007.6.4.7 SPI.2007.6.4.7 Clinical outcomes and complications after pedicle subtraction osteotomy for correction of thoracolumbar kyphosis Minoru Ikenaga Jitsuhiko Shikata Mitsuru Takemoto Chiaki Tanaka 4 2007 6 4 330 336 10.3171/spi.2007.6.4.8 SPI.2007.6.4.8 Inhibition of x-irradiation–enhanced locomotor recovery after spinal cord injury by hyperbaric oxygen or the antioxidant nitroxide tempol Virany H. Hillard Hong Peng Kaushik Das Raj Murali Chitti R. Moorthy Joseph D. Etlinger Richard J. Zeman 4 2007 6 4 337

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Patrick C. Hsieh, Stephen L. Ondra, Robert J. Wienecke, Brian A. O'Shaughnessy and Tyler R. Koski

morphology and equilibrium of pelvis and spine . Eur Spine J 11 : 80 – 87 , 2002 21 Wood KB , Geissele AE , Ogilvie JW : Pelvic fractures after long lumbosacral spine fusions . Spine 21 : 1357 – 1362 , 1996 22 Wood KB , Schendel MJ , Ogilvie JW , Braun J , Major MC , Malcom JR : Effect of sacral and iliac instrumentation on strains in the pelvis. A biomechanical study . Spine 21 : 1185 – 1191 , 1996 23 Yang BP , Ondra SL : A method for calculating the exact angle required during pedicle subtraction osteotomy for fixed

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Nimesh Patel, Bradley Bagan, Sumeet Vadera, Mitchell Gil Maltenfort, Harel Deutsch, Alexander R. Vaccaro, James Harrop, Ashwini Sharan and John K. Ratliff

patient cohort. Our complication profile is similar in both incidence and composition to other authors' reported incidences. 5 , 6 , 25 , 28 , 38 Buchl et al. 5 reviewed adverse events associated with pedicle subtraction osteotomy in a cohort of 78 patients. They reported nine cases of hardware failure (11.53% of patients), five of pseudarthosis (6.41%), five of wound infection (6.41%), and one of neurological deterioration (1.28%) as major complications. Also reported were a host of minor complications: four dural tears (5.13%), two postoperative radiculopathies (2

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Patrick C. Hsieh, Tyler R. Koski, Brian A. O'Shaughnessy, Patrick Sugrue, Sean Salehi, Stephen Ondra and John C. Liu

GC , Yoo JU , Wilbur G : Comparison of lumbar sagittal alignment produced by different operative positions . Spine 21 : 1802 – 1807 , 1996 36 Wiggins GC , Ondra SL , Shaffrey CI : Management of iatrogenic flat-back syndrome . Neurosurg Focus 15 : E8 , 2003 37 Yang BP , Ondra SL : A Method for calculating the exact angle required during pedicle subtraction osteotomy for fixed sagittal deformity: comparison with the trigonometric method . Neurosurgery 59 : 4 Suppl ONS458 – ONS463 , 2006

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Matthew L. Mundwiler, Khawar Siddique, Jeffrey M. Dym, Brian Perri, J. Patrick Johnson and Michael H. Weisman

, Glaser JA , Torner JC : Frac-tures of the thoracolumbar spine complicating ankylosing spondylitis . J Neurosurg 97 : 2 Suppl 218 – 222 , 2002 31 Karberg K , Zochling J , Sieper J , Felsenberg D , Braun J : Bone loss is detected more frequently in patients with ankylosing spondylitis with syndesmophytes . J Rheumatol 32 : 1290 – 1298 , 2005 32 Kim KT , Suk KS , Cho YJ , Hong GP , Park BJ : Clinical outcome results of pedicle subtraction osteotomy in ankylosing spondylitis with kyphotic deformity . Spine 27 : 612 – 618