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Pedicle Subtraction Osteotomy

Patient History: 65-year-old male presented with complaints of back pain and leg weakness after a multilevel low back minimally invasive decompression. All conservative measures proved ineffective. His x-rays show collapse of lumbar spine into scoliosis. He was treated with a scoliosis correction and decompression. Approximately one year later, he noted an inability to stand upright and x-rays revealed a broken pelvic screw. He underwent a second procedure involving a complex wedge cut of the spine known as a pedicle subtraction osteotomy.

Surgery: First surgery involved passive realignment and scoliosis correction. Patient did well with this surgery until his pelvic screw broke. The second surgery involved a complex spinal maneuver known as the pedicle subtraction osteotomy. Additionally, a 3 rod construct was employed for additional stability and support.

Fig.1 AP View Lumbar Spine

Fig.1 Frontal View Xray Showing Lumbar Spine Curve

Fig.1 PA View Corrected

Fig.2 Frontal View Xray Showing Lumbar Spine Correction

Fig.2 Lateral View Lumbar Spine

Fig.3 Side View Xray Showing Loss Disk height of Lumbar Spine

Fig.2 Lateral View Corrected

Fig.4 Side View Xray Showing Correction of Lumbar Spine

Broken Iliac (Pelvic) Screw - Post op check up

Fig.1 AP View - Broken Iliac Screw

Fig.1 Frontal View Xray Showing Left Broken Iliac (Pelvic) Screw

Fig.1 AP View Corrected

Fig.2 Frontal View Xray Showing Re-Alignment after Wedge Osteotomy

Fig.2 Lateral View Broken Iliac Screw

Fig.3 Side View Xray Showing Left Broken Iliac (Pelvic) Screw

Fig.2 Lateral View Corrected

Fig.4 Side View Xray Showing Re-Alignment After Wedge Osteotomy

Outcome: The patient now stands erect. He is able to walk further than before surgery. He still has mild back ache from time to time.