Rationale and techniques for Posterior Opening Wedge Osteotomy (POWO) in proximal junctional failure due to iatrogenic lumbar hyperlordosis - 29/10/21
, Andreas Tsoupras a, Jean-Charles Le Huec b
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Abstract |
Proximal junctional kyphosis (PJK) is a compensatory phenomenon in reaction to pathologic lumbar hyperlordosis. Inappropriate spinal curve harmony incurs risk of PJK. Postoperative failure of posterior instrumentation, with kyphosis resistant to revision surgery at the proximal junction, may be caused by excessive iatrogenic lumbar lordosis. The surgical attitude should be to decrease lumbar lordosis by posterior opening wedge osteotomy (POWO). We describe the rationale for POWO and surgical techniques at L3. The technique is illustrated by a case report at 24 months' follow-up. Based on rational analysis of the distribution of lordosis along the lumbar spine and of adaptation of the sitting position, POWO may be indicated to avoid PJK after revision surgery in adult spinal Deformation revision surgery.
El texto completo de este artículo está disponible en PDF.Keywords : Hyperlordosis-junctional kyphosis, Sagittal balance, Reverse pedicle subtraction osteotomy, Posterior opening osteotomya
Esquema
Vol 107 - N° 7
Artículo 102657- novembre 2021 Regresar al número
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