{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T04:14:42Z","timestamp":1762143282602,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Adult thoracolumbar kyphosis secondary to osteoporotic vertebral fractures (OVF) impairs the quality of life. Traditional 3CO provides correction but carries a high risk of complications, especially in the elderly. Minimally invasive anterior approaches may be safer. This study aims to compare the radiographic and clinical outcomes of septuagenarians with thoracolumbar kyphosis treated with single\u2010position navigated lateral column realignment with anterior longitudinal ligament release (LCR\u2010A) plus posterior column osteotomy (PCO) and posterior spinal fusion (PSF), or percutaneous pedicle screws (PPS) versus three\u2010column osteotomy (3CO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective study included 21 patients with LCR\u2010A and 54 with 3CO prospectively treated between March 2020 and April 2024. Radiographic parameters, the Oswestry Disability Index (ODI), SRS\u201022 scores, complications, and perioperative data were analyzed over a 2\u2010year follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Although LCR\u2010A patients were older, they had significantly reduced blood loss, shorter operative times, and fewer fused levels than 3CO patients. LCR\u2010A achieved comparable deformity correction, with fewer complications, lower postoperative ODI, and better SRS\u201022 scores. The LCR\u2010A group maintained radiographic correction, with fewer new neurological deficits and lower rates of infection, ileus, and delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Single\u2010position navigated LCR\u2010A is a safer and less invasive alternative to 3CO in elderly patients with thoracolumbar kyphosis, offering effective deformity correction, fewer complications, improved functional outcomes, and enhanced recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  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