T1 Pedicle Subtraction Osteotomy for Correction of Fixed Cervical Kyphotic Deformity: Surgical Technique and Review of the Literature

Fixed cervical or cervicothoracic kyphosis is a rare yet severely debilitating condition. When indicated, lower cervical or upper thoracic osteotomies may be used to address these deformities. This article describes the authors' preferred surgical technique for T1 osteotomy. Using this technique, surgical correction of approximately 30° at the osteotomy site can be achieved. Significant improvement in patient-reported outcome measures and quality of life have been reported following this procedure. Despite its potential benefits, this is a technically challenging procedure and has a high rate of postoperative complications-up to 56.5%-and patients should be counseled as to the risks of this procedure and potential complications before surgery.