Correction results from removing the deforming vertebral and disc components, then closing the resulting three-column defect in a controlled manner. This permits the spine to be realigned rather than relying only on limited bone reshaping. The extent of resection and closure must be coordinated with protection of neural structures throughout the correction.
Temporary fixation helps control the spine while vertebral and disc resection is performed, whereas definitive fixation stabilizes the reconstructed alignment after the defect has been closed. Using fixation in these stages supports controlled handling of the unstable spinal segment and helps preserve the intended correction through the remainder of the procedure.
It is considered when a deformity is too rigid or angular for less extensive osteotomies to provide adequate correction. The approach is therefore reserved for severe structural problems, including rigid kyphosis, major angular deformity, and congenital vertebral abnormalities. Careful selection is essential because the operation creates and reconstructs a substantial three-column defect.
The workflow includes staged posterior exposure, placement of temporary fixation, resection of the vertebra and associated disc components, and controlled closure of the three-column defect. Definitive fixation follows to secure the corrected alignment. Throughout these stages, meticulous planning and monitoring focus on maintaining stability and protecting neural structures.
Typical indications include rigid kyphosis, angular spinal deformity, congenital vertebral abnormalities, and selected destructive spinal tumors. Tumor-related cases require particularly careful selection because the lesion must be appropriate for this surgical strategy. The procedure is generally considered when the severity or rigidity of the problem exceeds what less extensive correction methods can address.
Treatment aims to improve spinal alignment and balance while potentially reducing pain and improving neurological function. These benefits depend on meticulous operative planning, controlled reconstruction, and monitoring that protects neural structures. Because the procedure is complex and destabilizes a three-column segment during resection, maintaining fixation and safe closure are central to the intended outcome.