Clinical Outcomes of V-Shaped Lamina Osteotomy in Correction of Spinal Deformities: A Technical Report

Siamak Shabani; Maziar Malekzadeh; Babak Mirzashahi

doi:10.18502/jost.v11i3.19404

Siamak Shabani Spine Fellowship, Department of Spine Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Maziar Malekzadeh Spine Fellowship, Department of Spine Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Babak Mirzashahi Associate Professor, Department of Spine Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v11i3.19404

Keywords: Osteotomy; Deformities; Kyphosis; Scoliosis

Abstract

Background: Multiple osteotomy techniques have been developed to manage spinal deformities by alleviating symptoms, restoring spinal alignment, and halting progression. Techniques such as Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO), bone-disc-bone osteotomy (BDBO), and vertebral column resection (VCR) vary in invasiveness and efficacy. Greater correction generally requires more extensive bone and soft tissue resection, which increases surgical complexity and the risk of complications. The V-shaped lamina osteotomy is a modified grade 1 posterior column osteotomy (PCO) designed to address multilevel deformities with reduced morbidity. This study evaluates its clinical safety and effectiveness.

Methods: In this retrospective analysis, 28 patients underwent multilevel V-shaped lamina osteotomy from 2005 to 2015. Diagnoses included idiopathic scoliosis (n = 7), degenerative scoliosis (n = 7), Scheuermann’s kyphosis (n = 4), and iatrogenic deformity (n = 10). Patients under 10 or over 80 years of age and those with traumatic, infectious, or malignant deformities were excluded.

Results: No intraoperative deaths, neurologic injuries, or major complications occurred. Two patients experienced superficial wound infections, which were resolved with debridement and antibiotics. All patients demonstrated significant sagittal and coronal alignment improvement. Mean blood loss was higher in patients undergoing four (or more)-segment osteotomies (350-500 ml) compared to those with two or three segments (200-300 ml). Surgical time ranged from approximately 4 hours for fewer segments to up to 6 hours for extensive procedures.

Conclusion: V-shaped lamina osteotomy is a safe, efficient technique for correcting multilevel spinal deformities. It offers comparable results to more invasive procedures while minimizing complications, making it suitable for long, smooth deformities.