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VIDEO: Percutaneous three-column osteotomy for kyphotic deformity correction in a congenital case

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In this video from the Open Operating Theatre, Nils Hansen-Algenstaedt, MD, from OrthoCentrum Hamburg in Hamburg, Germany, discusses how to perform a percutaneous three-column osteotomy in a 28-year-old woman with congenital T10-L1 kyphosis and progressive back pain.

Surgery begins with spinal needles used to identify T9-T12 vertebral bodies. This is followed by a midline incision made at T10, with dissection of the paravertebral muscles at the midline. Surgeons identify the screw entry points with intraoperative navigation and mark these with K-wires. Screws are placed percutaneously, and microscopic resection of the facet joints is performed. A complete laminectomy follows this.

Surgeons then perform an osteotomy at the disc level on the right side between T1- T12, and temporary rods are inserted. Osteotomy is then performed on the left side. The dural sac is shifted laterally. After the resected bone is removed, reduction is performed. Blockers are tightened, autogenous bone is added and the wound is closed.

This video is a teaching tool to help surgeons prepare for surgery or they can use it as a refresher on the surgical technique and indications for this surgery.