ABSTRACT: Study Design. A technical note and a retrospective review of cervical osteotomy using an innovative reduction technique.Objectives. To present the clinical and radiological outcomes and effectiveness of the sterile-freehand (SF) reduction technique for cervical osteotomy.Summary of Backgroud Data. For a successful osteotomy, controlled reduction of deformity after complete release of bony deformity is the most critical step. Conventional 'unscrubbed-scrubbed' manual reduction techniques necessitate multiple releases and retightening of the clamp and are inconvenient for surgeon to control the force and monitor the surgical field closely.Methods. A total of seven consecutive patients (5 males and 2 females, the mean age 52.6 years) who underwent corrective osteotomy of the fixed cervical kyphosis by a single surgeon were enrolled. Radiographically, C2-7 sagittal and coronal angle, and the chin-brow vertical angle (CBVA) were measured. In the prone position, the entire head and the Gardner-Wells tong were included in the surgical field and a sterile rope was connected to a weight trough a hole made in the surgical drape. After complete release of bony element and fixation of the caudal part of osteotomy with a pre-bent lordotic rod, the operator held the tong with right hand and gradually reduced the deformity to place the rod within the screw heads on the cranial part of osteotomy under close visual observation, with the support of the caudal part with left hand.Results. The type of osteotomy performed was pedicle subtraction osteotomy in 5 cases and anterior release-posterior osteotomy in 2 cases. The mean correction angle was 39.7˚ (28-63˚) on the sagittal plane and 9.3˚ (0-16˚) on the coronal plane. The mean correction of CBVA was 37.1˚ (18-61˚). There was no neurovascular complication.Conclusions. Using the SF reduction technique, the operator can obtain a safe, controlled reduction with close monitoring of the surgical field. The technique is potentially a simple and effective method to provide stable, three-dimensional reduction for corrective osteotomies of the cervical spine.
Spine 07/2012; · 2.08 Impact Factor