Spinal Osteotomies in Spinal Deformity Surgery: Anatomical Classification, Indications, and Surgical Techniques

Abstract

Background: Spinal osteotomies are essential surgical techniques used for the correction of complex spinal deformities affecting the sagittal and coronal planes. These procedures aim to restore spinal alignment, improve functional outcomes, and enhance quality of life in patients with deformity-related imbalance. The choice of osteotomy depends on the severity and rigidity of the deformity, underlying pathology, and desired degree of correction. Various osteotomy techniques have evolved over time, ranging from limited posterior element resections to extensive vertebral column resections. The anatomical classification proposed by Schwab and colleagues provides a standardized framework for categorizing spinal osteotomies into six grades according to the extent of bony and soft tissue resection. This review highlights the principles, indications, anatomical classification, surgical approaches, and correction capabilities of the commonly used spinal osteotomy techniques, with emphasis on their role in the management of spinal deformities.