65 year old female with previous lumbar laminectomies.
Very bad low back pain, only able to walk 20 feet, pain shooting down both legs.
Severe Thoracolumbar kyphosis on x-rays, no overall lumbar lordosis, positive sagittal alignment.
A same day combined anterior and posterior approach was required to correct this rigid deformity.
The T11-L5 discs were removed through anterior approach. A femoral ring from a tissue bank was placed at L3/4 and L4/5, bone chips were placed at the other levels.
The patient was then placed prone and Smith-Petersen osteotomies (SPO) were performed from T10-L5, and posterior fusion was from T4 to the pelvis with rods and screws.
Post operatively, the thoracolumbar junction kyphosis was corrected and clinical photographs show improved sagittal posture.