The Ponte Procedure

Geck, Matthew J.; Macagno, Angel; Ponte, Alberto M. da; Shufflebarger, Harry L.

doi:10.1097/bsd.0b013e31803d3b16

Cited by 201 publications

(33 citation statements)

References 11 publications

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“…It was termed a Smith-Petersen osteotomy, which has been performed by many authors. As a modification of this technique, there are procedures, such as Ponte procedure4 or polysegmental osteotomy5. Smith-Petersen et al3 devised their spinal operation as a one-stage procedure that could be repeated at more than one level if necessary.…”

Section: Smith-petersen Osteotomymentioning

confidence: 99%

Osteotomy of the Spine to Correct the Spinal Deformity

2009

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There are a number of reports on Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR). However, there are few systematic reviews of all three kinds of osteotomies. Literature review and author's experience of SPO, PSO and VCR osteotomy will be described. Various surgical techniques can be applied according to the disease entity and magnitude of the deformity. The most appropriate methods for deformity correction should be chosen and the potential complications should be considered. Before attempting an osteotomy of the spine for a spinal deformity, sufficient surgical experience and a thorough understanding of the anatomy of the spine and adjacent structures are needed. In addition, a well-organized team with the other departments is essential.

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Section: Smith-petersen Osteotomymentioning

confidence: 99%

Osteotomy of the Spine to Correct the Spinal Deformity

2009

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“…SPO was performed in the lumbar vertebral area at a 30°–40° angle of correction on a single level. However, due to high mortality rates and a high possibility of neurological complications, the method has not been commonly applied [1, 19, 20] and several modifications of this anterior opening wedge osteotomy have been described [3, 9, 10, 13, 21, 22]. …”

Section: Discussionmentioning

confidence: 99%

“…Polysegmental SPO has been particularly common and it has been possible to achieve a certain level of correction for coronal imbalance through the performance of asymmetric osteotomy [9, 10, 21]. SPO of a single segment has been reported to generally result in ~10° of correction.…”

Section: Discussionmentioning

confidence: 99%

Does it need to perform anterior column support after Smith-Petersen osteotomy for ankylosing spondylitis?

Kim

Park

et al. 2011

Eur Spine J

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PurposeThe aim of this study was to determine whether anterior column support is required in Smith-Petersen osteotomy procedure with correction angles of more than 10°, while examining the subsequent healing patterns in relation to the disrupted area.MethodsAn analysis was done on 26 segments of 19 patients who showed a correction angle of more than 10° in the anterior opening after SPO. There were 17 male and two female patients with a mean age of 40 years (24–56 years). The mean follow-up period was 6.5 years (2–9.1 years). The patients were classified according to the site of the anterior opening, as the disc level, the lower end-plate of the upper body (upper body), or the upper end-plate of the lower body (lower body). The healing patterns of anterior opening and the radiological correction angles were evaluated relative to the opening site.ResultsIn all cases, bony fusion was confirmed at a mean period of 5.6 months (3–6.7 months) after surgery and the anterior opening gap was healed in 18 segments (69.2%). For patients that developed an opening in the upper body, all of the gaps were healed. The gaps in the lower body opening group were healed in 85.7% of the cases, and for the opening at the disc level, the gaps were healed only in 12.5% of the cases. The least amount of correction was obtained when anterior opening occurred in disc level.ConclusionsIn our study of subjects presenting with anterior opening angles from 10° to 32°, we obtained successful fusion without the need for additional anterior interbody fusion. Improved gap healing and increased correction angles were obtained when the opening was present in the upper or lower body endplates compared to those at the disc space level.

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“…Flexible malformations are usually managed by Ponte osteotomies and fixation from a single posterior approach, while for plain, immobile deformities, release from the anterior might be obligatory before the posterior step (5,10,47). Like other deformity operations, intra-operative nerve monitoring is suggested to attentive the surgeon while any spine handlings reason fluctuations in motor evoked potentials or somatosensory evoked potentials.…”

Section: Surgical Approachmentioning

confidence: 99%

“…This type of osteotomy includes subtraction of the spinous process, inferior facets, inferior lamina, and a slice of the superior facets of the lower level. Caution must be taken to eliminate any osseous barbs and original ligament of flavum that can buckle into the spinal cord once the deformity is adjusted (25,46,47,49). Most physicians today custom pedicle screws at many levels.…”

Section: Posterior Approachmentioning

confidence: 99%

Scheuermann’s Disease: New Impressions of Clinical and Radiological Evaluation and Treatment Approaches; A Narrative Review

Haddadi

Kadam

Tannoury³

et al. 2018

J Pediatr Rev

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Context: Scheuermann's disease (kyphosis) is an essential kyphosis of the thoracic spinal column, and it is the most public source of kyphosis in adolescents. It has been shown that the imaging characteristics of the disease are sequential 3 vertebrae by minimum 5 degrees of wedging of anterior part of vertebral body. Frequently, the disease is presented at 8 to 12 years of age. Kyphosis is regularly managed with conservative methods. The purpose of this review was to discuss challenging issues in evaluation and treatment of this disease in the mentioned age group. Evidence Acquisition: Medline, Google scholar, PubMed and Ovid were searched and a total of 44 articles were found to be involved in the pediatric evaluation of this disease.Results: The precise basis of Scheuermann's kyphosis remnants is unidentified. Diagnosis is made by careful clinical examination and radiologic evaluations. In neurologic defects, MRI must be taken. Conservative managing plans for SK involve observation, physical therapy, and bracing. Some writers recommended evading the operation till skeletal maturity is completed. Surgery is commonly suggested for patients with deformity progress, permanent pain, neurological discrepancy, pulmonary insufficiency, or cosmetic complain. Thoracic kyphosis with curving of smaller than 75 degrees seldom requires surgery. Posterior only or combined with anterior methods are the surgery options based on severity of disease. Conclusions: Today, new and more modern braces have been designed to increase global advantages of bracing in Scheuermann's disease. Patients with more than 75 degrees of curving, kyphotic progress, intolerable cosmetic features, or neurological discrepancy might be supposed for operation. New surgical procedures permit improved correction of the deformity via posterior surgery with lesser complication rates. Concurrent shortening of the posterior spinal column crossways the apical levels, combined by monitoring of spinal cord, decreases the danger of neurological deficits. Though patients state great satisfaction rates through surgery, both proximal and distal junctional complications can remain. New systems with dynamic instrumentation and improving surgical methods with biologic handling are almost convinced to become typical treatment possibilities.

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The Ponte Procedure

Abstract: Therapeutic study, level IV [case series (no, or historical, control group)].

Cited by 201 publications

References 11 publications

Osteotomy of the Spine to Correct the Spinal Deformity

Osteotomy of the Spine to Correct the Spinal Deformity

Does it need to perform anterior column support after Smith-Petersen osteotomy for ankylosing spondylitis?

Scheuermann’s Disease: New Impressions of Clinical and Radiological Evaluation and Treatment Approaches; A Narrative Review

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