Posterior osteotomy techniques for rigid cervical deformity correction.

Posterior cervical osteotomies are powerful techniques for the correction of rigid cervical deformity. These include a variety of subtypes including partial facet joint resection, complete facet joint resection, opening wedge osteotomy (OWO), and closing wedge osteotomy (CWO). The partial facet joint resection provides limited lordosis but can be applied across multiple levels and provides bony surface for fusion. Complete facet joint resection can also be performed across multiple segments for a cumulative effect and like the partial facet joint resection requires mobility of the anterior column. The OWO is traditionally performed at C7 and involves complete a complete laminectomy, facetectomy, and pediculectomy with special care to fully decompress the C8 nerve roots prior to osteotomy closure. The osteotomy utilizes a fulcrum of rotation in the middle column with shortening of the posterior column and lengthening of the anterior column with an osteoclastic fracture that must be performed with significant care. The CWO is similar to an OWO with the addition of an osteotomy into the vertebral body that is closed like a pedicle subtraction osteotomy (PSO). The goal of this review article is to summarize posterior osteotomy techniques for cervical deformity correction.
Competing Interests: Conflicts of Interest: The series “Advanced Techniques in Complex Cervical Spine Surgery” was commissioned by the editorial office without any funding or sponsorship. LAT serves as the unpaid editorial board member of Journal of Spine Surgery from Jan. 2019 to Jan. 2021. LAT served as the unpaid Guest Editor of the series. The other authors have no conflicts of interest to declare.
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