Adult Post-Laminectomy Kyphoscoliosis

Posterior Osteotomy
NW required multiple posterior osteotomies (called “Smith-Peterson” or “Ponte Osteotomies”) to straighten her spine to normal degrees of kyphosis. Normally the vertebra contact each other through 3 joints at each level: one disc in the front, and two sliding facets in the back. In the thoracic spine, the facets look like shingles on a roof, and will only allow you to bend backward so far. In this osteotomy, we remove the facets and bend the spine backward further than normal. Over one level, only a little bit of correction will occur (5-15 degrees). However, over many levels, large amounts of correction can be achieved.

A 65 year old woman had a prior laminectomy of her spine to remove radiating leg pain. Over time, she found it was impossible to stand up straight. Dr. Rinella noticed the prior procedure destabilized the spine, and she developed flatback or fixed sagittal imbalance. Because the curves involved the entire spine, she required a long fusion from her shoulders to her hips. Today she can stand up straight without pain or difficulty.