{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:28:12Z","timestamp":1790998092073,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe spinal osteotomy in lateral position, which might be a new strategy for correcting thoracolumbar kyphotic deformity combined with severe hip flexion contracture, and to present two cases in which this method was successfully performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Spinal osteotomies in lateral position were performed in two patients with severe thoracolumbar kyphosis combined with hip flexion contracture, which was not suitable for operation in the prone position. Case 1: a 33\u2010year\u2010old female AS patient still had severe hip flexion contracture due to poor rehabilitation after total hip replacement (THR). The range of movement of the hip was only about 15\u00b0 in right and 10\u00b0 in left. Pre\u2010operativethoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), and sagittal vertical axis (SVA) were 52.4\u00b0, 49.1\u00b0, 42.7\u00b0, and 315\u2009mm, respectively. Pedicle subtraction osteotomy (PSO) at L3 was performed in the lateral position. The eggshell procedure was used during osteotomy. Case 2: a 45\u2010year\u2010old male AS patient presented coexisting rigid thoracolumbar kyphosis and hip flexion contracture. The range of movement of the hip was only about 20\u00b0 in right and 25\u00b0 in left. Pre\u2010operativeTK, TLK, LL and SVA were 34.9\u00b0, 66.8\u00b0, 58.8\u00b0 and 290.8\u2009mm, respectively. PSO at L<jats:sub>2<\/jats:sub> was performed in lateral position. The eggshell procedure was also used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sagittal malalignments of both patients were greatly improved. For case 1, the total operation time was 5.5\u2009h. The blood loss was 1500\u2009mL and the amount of allogeneic blood transfusion was 1580\u2009mL during the operation. SVA was reduced to 127\u2009mm and LL decreased from preoperative 42.7\u00b0 to \u221228.4\u00b0. The correction angle through L<jats:sub>3<\/jats:sub> was 34.7\u00b0 and the correction angle through the osteotomy segment was 62.9\u00b0. For case 2, the duration of surgery was 6.5\u2009h. The operative blood loss was 2000\u2009mL and the total amount of blood transfusion was 2020\u2009mL. SVA was reduced to 209.8\u2009mm and LL decreased from preoperative 58.8\u00b0 to 9.2\u00b0.The correction angle through L<jats:sub>2<\/jats:sub> was 37.1\u00b0 and the correction angle through the osteotomy segment was 55\u00b0. No intra\u2010operative or post\u2010operative complications were observed. Six months after PSO, case 1 had good posture for standing and sitting. The case 2 underwent bilateral THRs nine months after PSO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PSO could be performed in the lateral position successfully. For AS patients who cannot be placed in the prone position due to coexisting severe thoracolumbar kyphosis and hip flexion contracture, performing spinal osteotomy in the lateral position as the first step is an alternative.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13169","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T08:58:24Z","timestamp":1637744304000},"page":"2396-2404","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pedicle Subtraction Osteotomy in Lateral Position: A New Strategy for Correcting Severe Thoracolumbar Kyphosis Combined with Hip Flexion Contracture in Ankylosing Spondylitis"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6680-8198","authenticated-orcid":false,"given":"Di\u2010yu","family":"Song","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The First Medical Centre, Chinese PLA General Hospital  Beijing China"},{"name":"Department of Orthopaedics PLA Rocket Force Characteristic Medical Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6656-6782","authenticated-orcid":false,"given":"Zi\u2010fang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Medical Centre, Chinese PLA General Hospital  Beijing China"},{"name":"The School of Medicine Nankai University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian\u2010hao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Medical Centre, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deng\u2010bin","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Medical Centre, Chinese PLA General Hospital  Beijing 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