{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:34:10Z","timestamp":1784565250249,"version":"3.55.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,5]]},"abstract":"\nOBJECTIVE<\/jats:title>\nPedicle subtraction osteotomy (PSO) is a powerful but high-risk surgical technique for destabilizing the spine for deformity correction in both the sagittal and coronal planes. Numerous reports have demonstrated the benefits of this technique for realigning the spine in a physiological posture; however, the open surgical technique is associated with a high complication rate. In this report the authors review data obtained in a series of patients who underwent PSO through a less invasive approach.<\/jats:p><\/jats:sec>\n\nMETHODS<\/jats:title>\nSixteen patients with severe coronal- and\/or sagittal-plane deformities were treated in this series. Conservative measures had failed in all cases and patients had undergone a single-level PSO or extended PSO at L-2 or L-3. Fixation was accomplished using percutaneous instrumentation and interbody or facet joint fusions were used at the remaining levels. None of the procedures were aborted or converted to a traditional open procedure. Standard clinical and radiographic measures were used to assess patient outcomes.<\/jats:p><\/jats:sec>\n\nRESULTS<\/jats:title>\nMean age was 68.8 years and mean follow-up duration was 17.7 months. An average of 7.6 levels were fused, and 50% of the patients had bilateral iliac screw fixation, with all constructs crossing both the thoracolumbar and lumbosacral junctions. Operative time averaged 356 \u00b1 50 minutes and there was a mean blood loss of 843 \u00b1 339 ml.<\/jats:p>\nThe leg visual analog scale score improved from a mean of 5.7 \u00b1 2.7 to one of 1.3 \u00b1 1.6, and the back visual analog scale score improved from a mean of 8.6 \u00b1 1.3 to one of 2.4 \u00b1 2.1. The Oswestry Disability Index score improved from a mean of 50.1 \u00b1 14.4 to 16.4 \u00b1 12.7, representing a mean reduction of 36.0 \u00b1 16.9 points. The SF-36 physical component summary score changed from a mean of 43.4 \u00b1 2.6 to one of 47.0 \u00b1 4.3, and the SF-36 mental component summary score changed from a mean of 46.7 \u00b1 3.6 to 46.30 \u00b1 3.0.<\/jats:p>\nCoronal alignment improved from a mean of 27.9 \u00b1 43.6 mm to 16.0 \u00b1 17.2 mm. The lumbar Cobb angle improved from a mean of 41.2\u00b0 \u00b1 18.4\u00b0 to 15.4\u00b0 \u00b1 9.6\u00b0, and lumbar lordosis improved from 23.1\u00b0 \u00b1 15.9\u00b0 to 48.6\u00b0 \u00b1 11.7\u00b0. Pelvic tilt improved from a mean of 33.7\u00b0 \u00b1 8.6\u00b0 to 24.4\u00b0 \u00b1 6.5\u00b0, and the sagittal vertical axis improved from 102.4 \u00b1 73.4 mm to 42.2 \u00b1 39.9 mm. The final lumbar lordosis\u2013pelvic incidence difference averaged 8.4\u00b0 \u00b1 12.1\u00b0. There were 4 patients who failed to achieve less than or equal to a 10\u00b0 mismatch on this parameter. Ten of the 16 patients underwent delayed postoperative CT, and 8 of these had developed a solid arthrodesis at all levels treated. A total of 6 complications occurred in this series. There were no cases of symptomatic proximal junction kyphosis.<\/jats:p><\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nAdvancements in minimally invasive technique have resulted in the ability to manage increasingly complex deformities with hybrid approaches. In this limited series, the authors describe the results of utilizing a tissue-sparing mini-open PSO to correct severe spinal deformities. This method was technically feasible in all cases with acceptable radiographic outcomes similar to open surgery. However, high complication rates associated with these deformity corrections remain problematic.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.7.spine15188","type":"journal-article","created":{"date-parts":[[2016,1,8]],"date-time":"2016-01-08T15:02:59Z","timestamp":1452265379000},"page":"769-776","source":"Crossref","is-referenced-by-count":46,"title":["Mini-open pedicle subtraction osteotomy as a treatment for severe adult spinal deformities: case series with initial clinical and radiographic outcomes"],"prefix":"10.3171","volume":"24","author":[{"given":"Michael Y.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Bordon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hospital Manises, Valencia, 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