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A Modified Staged Three-Level Pedicle Subtraction Osteotomy Approach for Severe Ankylosing Spondylitis Using CT Navigation and Ultrasonic Bone Scalpel

Year: 2026

Type: article

Abstract: Pedicle subtraction osteotomy (PSO) is a well-established technique for correcting rigid spinal deformities but remains technically demanding and carries notable risks. We describe a modified three-level PSO technique utilizing CT-guided navigation and an ultrasonic bone scalpel in a patient with severe sagittal imbalance secondary to ankylosing spondylitis. The procedure achieved satisfactory deformity correction with maintained clinical and radiographic improvement at 24 months. While further experience is needed to assess its broader applicability, this case suggests that incorporating modern navigation and precision tools may help optimize the safety and efficiency of complex PSO procedures.

Source: Cureus

DOI: 10.7759/cureus.101882

Authors: Rawan Masarwa, Nigil S Palliyil, Sultan Al-Kalbani, Hussein Akil, Elie Najjar, Nasir A Quraishi

Institutions: Nottingham University Hospitals NHS Trust, Queen's Medical Centre, University of Balamand

Language: English

Topic: Scoliosis diagnosis and treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7124939807

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Cites: 13

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