Posterior Column Osteotomy

How is a Posterior Column Osteotomy Performed?

Specifically, the “posterior” part of a PCO means that your surgeon will access your spine from the back side.

After making a small incision, your surgeon will insert pedicle screws into your vertebrae. These screws are mounted to the posterior spinal column, above and below the osteotomy site.

Then, the bone removal process can begin. Your surgeon will remove and/or trim your:

    • Spinous Process: The bony “point” on the back-side of each vertebrae
    • Lamina: The sheath that houses your spinal cord
    • Facet Joints: The bony joint where two vertebrae connect to create movement
    • Ligamentum Flavum: The stretchy tissue that connects one vertebra to another
      After “loosening” your spine, your doctor will adjust your vertebrae into the correct positions. This key process often requires the use of implants to maintain proper alignment.

With the spine in its ideal position, your doctor will attach rods to the screws to hold your spine in place. Sometimes, a bone graft from the patient is used to reinforce the posterior vertebral column. As the graft matures, the back side of your spine will fuse together. Because only a few vertebrae undergo the fusion process, you will maintain mobility in your back.

Lastly, your doctor will close the incision and you will receive after-care instructions.

One PCO can give up to 20 degrees of improvement in curvature. For worse curves, more than one PCO may be needed.

Do I Qualify for a Posterior Column Osteotomy?

You may need a PCO if you have scoliosis, Scheuermann’s kyphosis, or flatback syndrome.

However, if you have scoliosis or kyphosis, your curve must be severe (45 degrees or higher). If this does not apply to you, then non-surgical options, like scoliosis bracing, may work best.

Unfortunately, a PCO will not be able to help everybody. When we remove bone, our spinal discs must be strong enough to support the spine in its absence. If you have weak discs, you may need a spinal fusion instead.

To find out if you qualify for PCO, contact Dr. Lowenstein. An expert at PCO, Dr. Lowenstein will get you on the path to recovery!