Osteotomies for the Correction of Cervical Deformity: When, How, and Why?

Study design: CSRS - Deformity Issue.

Objective: This review focuses on the current understanding of osteotomy techniques for cervical deformity correction, with an emphasis on indications, decision-making, and surgical technique.

Background: Cervical deformity is a challenging condition that often leads to significant functional impairment, including issues related to posture, pain, neurological status, and psychosocial problems. Surgical correction of these deformities, particularly through osteotomy, is a crucial part of the treatment paradigm, and osteotomy is required for significant fixed deformity.

Methods: A review of the literature on osteotomy techniques, including posterior column osteotomy (PCO), pedicle subtraction osteotomy (PSO), and anterior osteotomy was conducted. Current indications, complications, and outcomes of these procedures were analyzed.

Results: Cervical deformity osteotomies have evolved significantly, with techniques like PCO and PSO being central in realigning the cervical spine. The choice of technique depends on deformity characteristics, including rigidity and location, and requires a tailored approach. The cervicothoracic junction has emerged as a key region for correction.

Conclusion: Osteotomy remains a powerful tool in the correction of cervical deformities, offering improvements in alignment, function, and quality of life. Future innovations in surgical planning, minimally invasive techniques, and robotics hold promise for improving outcomes and reducing complications.