Posterior Cervicothoracic Osteotomy

Indications

• Severe kyphotic deformity at the cervicothoracic spine that causes radiculopathy, myelopathy, pain, restriction of gaze, or dysphagia. The deformity may arise from postlaminectomy destabilization, junctional kyphosis above a fused level, or primary diseases affecting the spine (particularly ankylosing spondylitis). C7 plumb line may be normal.

• Other forms of kyphosis include postinfection, posttumor, posttrauma, and postsurgical fusion kyphosis.

• Dorsal osteotomy allows for greater deformity correction. Mean correction angles have been cited in the literature to range from 23.3 to 53.8 degrees based on Cobb angles (35 to 52 degrees based on CBV angles) compared with mean correction via ventral only approach ranging from 11 to 32 degrees.