Difficult Multi-Revision Procedure

NW had a rare spinal cord tumor when she was young, and required several spinal procedures at a major children’s hospital. Along the way, several pedicle screws broke (due to failed fusion), and she slowly leaned to her left. NW came to see Dr. Rinella when she developed severe leg pain. Imaging studies demonstrated the bottom of the fusion did not heal, and she developed spinal stenosis that caused her leg pain. Due to the multiple anterior procedures and radiation treatments, Dr. Rinella performed a staged anterior-posterior osteotomy to avoid injuring the nerves. He was able to realign her spine so she could stand up straight at her wedding!

Anterior-Posterior Osteotomy
The anterior-posterior osteotomy is very similar to a vertebral column resection. In a vertebral column resection, an entire vertebra or more are removed from the back of the spine. This dislocates the spine so it can be repositioned properly. The anterior-posterior osteotomy has the same effect, but the back portion of the bone is removed from the back fo the spine, and the front portion is removed from a separate anterior incision. This avoids reaching around the nerves to remove all of the vertebra.