Thoracolumbar osteotomy for postsurgical sagittal imbalance.

A prospective study of 12 patients with sagittal plane imbalance after multiple surgeries for scoliosis is reported. Reconstruction was attempted by posterior thoracolumbar junction osteotomy. Eighty-seven degrees of thoracic kyphosis (ending at L3) was improved to forty-one degrees (ending at T12). Lumbar lordosis was increased from 21 to 30 degrees, beginning at L1 afterward (L3 before). 8.7 cm posterior displacement of the sagittal weight-bearing axis was achieved. No permanent complications ensued. The procedure, without anterior surgery, corrects the deformity at the apical area. Cotrel-Dubousset instrumentation secured correction and fixation.