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Summary of sagittal balance-correction osteotomy

SPO/PontePSO CategoryVCR
Schwab grade1 and 23 and 45 and 6
Resection areaPosterior element onlyIncluded part of vertebral bodyEntire vertebra
IndicationLong, gradual, rounded kyphosis, eg, Scheurmann kyphosisSharp, focal kyphosis with fixed disc space, ie, SPO not applicableSharp, focal kyphosis at thoracic vertebra
Hemivertebra resection
Vertebral tumor resection
Need disc space mobility?YesNoNo
Sharp angular kyphosis correction?NoYesYes
Thoracic spine correction?NoNoYes
Kyphotic curvature correction∼10°/level30°–40°/level45°–70°
Indicated SVA (cm)>6–8 cm but <10 cm (positive SVA)>10–12 cm (very positive SVA)
Mean neurologic/overall complication rate (%)272.1/40.49.1/38.514.3/39