成人严重的僵硬的脊柱畸形，包括冠状位和失状位的畸形。通过截骨最终取得失状位和冠状位的平衡，缓解疼痛，坚固的融合(rónghé)及预防进一步畸形。第一页，共二十二页。第二页，共二十二页。第三页，共二十二页。(shīhénɡ)(shīhénɡ)1、节段性tape1（segmental）:SVA<5cm2、整体性tape2（global）:SVA>5cmwithoutkneeflexionorhiphyperextensionIdealsagittalalignmentisdescribedasSVA<50mm,PT<25゜,PI–LL=10゜第四页，共二十二页。(shīhénɡ)(shīhénɡ)1、Smith-Petersenosteotomy(SPO)2、pediclesubtractionosteotomy(PSO)3、bone-disc-boneosteotomy(BDBO)4、vertebralcolumnresection(VCR)第五页，共二十二页。removalofposteriorligamentsandfacets第六页，共二十二页。•widefacetectomytopreventnerverootimpingement•osteotomysitecanbedoneasymmetricallytocorrectcoronalimbalanceaswellassagittalimbalance第七页，共二十二页。9.3–10.7perlevel.substantialcorrection,itmaybenecessarytograftthediscspaceanteriorlyType1along,rounded,smoothkyphosisSVAintherangeof6–8cmpositive.easierandsaferthanotherosteotomies;第八页，共二十二页。•Thomasenin1985.Heiningetaleggshellosteotomy.第九页，共二十二页。30to40correctionthroughallthreecolumns,whileavoidingstretchvesselsandvisceraanteriortothespine;Ifperformedinanasymmetricfashion,providesignificantcoronalcorrectionaswell;第十页，共二十二页。type2sagittaldeformity(SVA>12cm),sharp,angularkyphosisetl；第十一页，共二十二页。•Awidelaminectomyisperformed•Osteotomylinehorizontaltothesacrum•Placingthetemporaryrod•closedovertherodswhilethehipsandkneesarehyperextended第十二页，共二十二页。InterbodyfusioncanbedoneaseitheraTLIForanALIFprocedure第十三页，共二十二页。correctionrates35°to60°Themainindicationsaredeformitieswiththediscspaceastheapexorcenterofrotationalaxis(CORA)andseveresagittalplanedeformities第十四页，共二十二页。第十五页，共二十二页。第十六页，共二十二页。第十七页，共二十二页。•pediclescrewsatleasttwolevelsbelowandthreelevelsabove•Atitaniummeshcagecanbeplacedanteriorlyifdesired.第十八页，共二十二页。in1922byMacLennanindicatedforrigidmultiplanardeformities,sharpangulateddeformities,emivertebraresections,resectablespinaltumours,posttraumaticdeformities,andspondyloptosis.第十九页，共二十二页。第二十页，共二十二页。第二十一页，共二十二页。内容(nèiróng)总结脊柱畸形截骨术。失状位失衡(shīhén)ɡ截骨方式Posterior-only。1、Smith-Petersenosteotomy(SPO)。3、bone-disc-boneosteotomy(BDBO)第二十二页，共二十二页。
