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Summary of sagittal balance-correction osteotomy
SPO/Ponte PSO Category VCR Schwab grade 1 and 2 3 and 4 5 and 6 Resection area Posterior element only Included part of vertebral body Entire vertebra Indication Long, gradual, rounded kyphosis, eg, Scheurmann kyphosis Sharp, focal kyphosis with fixed disc space, ie, SPO not applicable Sharp, focal kyphosis at thoracic vertebra Hemivertebra resection Vertebral tumor resection Need disc space mobility? Yes No No Sharp angular kyphosis correction? No Yes Yes Thoracic spine correction? No No Yes Kyphotic curvature correction ∼10°/level 30°–40°/level 45°–70° Indicated SVA (cm) >6–8 cm but <10 cm (positive SVA) >10–12 cm (very positive SVA) Mean neurologic/overall complication rate (%)27 2.1/40.4 9.1/38.5 14.3/39