What is the effect of a pedicle subtraction osteotomy PSO on the anterior middle and posterior column

A PSO hinges on the anterior column and closes the middle and posterior columns (Fig. 52-2).

Before After

Before After

Figure 52-1. Smith-Petersen osteotomy. (From Booth KC, Bridwell KH, Lenke LG, et al. Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine 1999;24:1712-20.)

Before After

Before After

Figure 52-2. Three-column pedicle subtraction osteotomy. (From Booth kC, Bridwell KH, Lenke LG, et al. Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine 1999;24:1712-20.)

Figure 52-1. Smith-Petersen osteotomy. (From Booth KC, Bridwell KH, Lenke LG, et al. Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine 1999;24:1712-20.)

Figure 52-2. Three-column pedicle subtraction osteotomy. (From Booth kC, Bridwell KH, Lenke LG, et al. Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine 1999;24:1712-20.)

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