Vertebral Wedge Osteotomy

Rheumatoid (ankylosing) spondylitis occurs infrequently in women, in whom it appears to run a milder course. Though a rigid lumbar kyphosis is a common sequela of ankylosing spondylitis, only a small number of patients require osteotomy of the spine. The case is presented of a young woman on whom wedge osteotomy was performed successfully. A method of posterior vertebral body wedge resection for correction of lumbar kyphosis in patients with ankylosing spondylitis is described. The method consists of resection of a portion of the posterior neural elements, lumbar disc, and vertebral body with subsequent manipulation of the spine into extension. The principle of the modified surgical method prevents lengthening of the lumbar spine, thus eliminating stretching and injury to juxtaposed organs.