Pedicle-sparing transforaminal thoracic spine wedge osteotomy for kyphosis correction

BACKGROUND: Correction of a focal kyphotic deformity at times requires performing a pedicle subtraction osteotomy, which is accompanied by loss of pedicles as anchor points at the affected level in addition to significant blood loss. To help alleviate these two issues, a novel osteotomy technique for correction of kyphosis using a transforaminal approach to the thoracic vertebral body is described. METHODS: We describe a bilateral pedicle-sparing approach and demonstrate it in a patient with proximal junctional kyphosis. RESULTS: The proposed osteotomy resulted in a 28-degree Cobb angle improvement in the sagittal plane. CONCLUSION: The operation resulted in a similar degree of correction as a pedicle subtraction osteotomy, with the added benefit of maintaining the pedicles closest to the kyphotic deformity.