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Deformity Procedures in Carmel, IN PSO (Pedicle Subtraction Osteotomy)

Introduction to Pedicle Subtraction Osteotomy (PSO)

Correct Complex Spinal Deformity and Alignment

A significant spinal deformity can make it difficult to maintain an upright posture and may cause pain, fatigue, or limitations with standing and walking. When the spine has become too rigid to achieve adequate correction with less extensive techniques, a pedicle subtraction osteotomy (PSO) may be considered. Dr. Peter Swiatek uses this spinal reconstruction technique in carefully selected patients who require substantial correction of their spinal alignment in Carmel, Indianapolis, Westfield, and Kokomo, IN.

Surgeon's gloved hand selecting green surgical instruments from sterile tray during medical procedure - PSO in Carmel, IN

What is Pedicle Subtraction Osteotomy?

A pedicle subtraction osteotomy is a spinal deformity procedure in which a wedge-shaped section of bone is removed from a vertebra to allow the alignment of the spine to be changed. After the wedge is removed, the vertebra is carefully closed into the newly created space, producing a controlled correction at that level. Screws and rods are used to maintain the corrected alignment, and spinal fusion is performed to make the treated area permanently stable. PSO is generally reserved for significant, rigid deformities that cannot be adequately corrected using positioning, implants, or less extensive osteotomy techniques.

Who Are the Best Candidates for Pedicle Subtraction Osteotomy?

A PSO is a complex procedure and is not necessary for most patients with spinal conditions or even every patient with a spinal deformity. Dr. Swiatek may consider the procedure when a significant, fixed alignment problem drives symptoms or functional limitations and less extensive techniques cannot achieve sufficient correction. PSO can be a powerful technique for patients who have previously failed spinal fusion surgery. Candidates may include patients around Carmel, Indianapolis, Westfield, and Kokomo who:

  • Have a significant, rigid spinal deformity affecting overall alignment
  • Have difficulty maintaining an upright posture because of the deformity
  • Require substantial correction that cannot be achieved with less extensive surgical techniques
  • Are medically able to undergo a complex spinal reconstruction and understand the recovery involved

What Are the Benefits of Pedicle Subtraction Osteotomy?

The primary purpose of a PSO is to restore a more appropriate spinal alignment when a rigid deformity prevents the patient from standing upright comfortably. The amount and location of the correction are carefully planned based on the individual’s anatomy and overall spinal alignment. Potential benefits include:

  • Provides substantial correction of a rigid spinal deformity
  • Improves the ability to maintain a more upright and balanced posture
  • Can reduce the physical effort required to compensate for abnormal spinal alignment
  • Allows correction to be incorporated into a larger spinal reconstruction when necessary
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How to Begin Your Pedicle Subtraction Osteotomy Journey

Determining whether a PSO is appropriate requires a detailed evaluation of the entire spine rather than focusing on a single vertebra or area of pain. During a consultation in Carmel, Indianapolis, Westfield, and Kokomo, Dr. Swiatek evaluates the location and severity of the deformity, prior spinal procedures, overall alignment, symptoms, and general health to develop a surgical plan.

  • Complete a Spine Evaluation: Discuss your symptoms, functional limitations, medical history, and any previous spinal procedures with Dr. Swiatek.
  • Evaluate Your Alignment: Standing X-rays and other imaging studies can be used to measure spinal alignment and determine the origin of the deformity. CT or MRI imaging may also be needed depending on the condition.
  • Review Previous Treatment: Dr. Swiatek will consider non-surgical care and previous operations, particularly when the deformity has developed following an earlier spinal fusion or other spine surgery.
  • Develop a Surgical Plan: If a PSO is appropriate, Dr. Swiatek will explain where the osteotomy will be performed, the planned correction, any other procedures that may be required, and what to expect during recovery.

What to Expect on the Day of Pedicle Subtraction Osteotomy Surgery

A pedicle subtraction osteotomy is performed under general anesthesia and is often part of a larger spinal reconstruction. After accessing the spine from the back, Dr. Swiatek places spinal instrumentation to provide control and stability during the correction. A carefully planned wedge of bone is removed from the selected vertebra, including portions of the structures known as the pedicles that connect the front and back portions of the vertebra. The wedge is then gradually closed to adjust the spine’s angle and improve overall alignment. Screws and rods maintain the corrected position, and a bone graft is placed to support spinal fusion. Since PSO is an extensive procedure, patients require close monitoring after surgery before gradually beginning postoperative movement and rehabilitation.

Dr Peter Swiatek wearing surgical loupes with LED headlight for precision medical procedures - in Carmel, IN

Pedicle Subtraction Osteotomy Recovery

Your Guide to Post-Pedicle Subtraction Osteotomy Care

Recovery following a PSO and deformity correction surgery is generally more extensive than recovery from smaller decompression or limited fusion procedures. After surgery, patients begin walking and gradually increase movement under the guidance of their care team. Bending, twisting, heavy lifting, and strenuous activities remain restricted while the spine heals and fusion develops. Follow-up appointments and imaging allow Dr. Swiatek to monitor spinal alignment, hardware, fusion, and overall recovery. The timeline for returning to work, driving, exercise, and other activities varies according to the extent of the reconstruction and each patient’s progress, and complete recovery can take several months.

How Much Does Pedicle Subtraction Osteotomy Cost in the Carmel and Indianapolis Area?

The cost of pedicle subtraction osteotomy in the Carmel, Indianapolis, Westfield, and Kokomo area varies according to the complexity of the spinal deformity and the extent of reconstruction required. Insurance typically covers the type of surgery requiring a PSO and deformity correction. Our billing department is available to answer your questions regarding PSO and spinal deformity surgery.

Philosophy

Why Choose Dr. Swiatek?

Dr. Peter Swiatek is a board-certified, fellowship-trained orthopaedic spine surgeon, serves patients in Carmel, Indianapolis, Westfield, and Kokomo, IN, and is a fellowship-trained spine surgeon with specialized experience in treating spinal deformity and complex revision and failed spine surgery cases. He completed his orthopedic surgery residency at Northwestern Memorial Hospital and his spine surgery fellowship at the Rothman Institute and Thomas Jefferson University Hospital.

Dr. Swiatek emphasizes surgical safety, evidence-based care, and patient-specific treatment, focusing on performing the right amount of surgery to address the underlying problem adequately. His academic background includes more than 55 peer-reviewed publications, and he is a member of the American Academy of Orthopedic Surgeons (AAOS), North American Spine Society (NASS), and the American Board of Orthopaedic Surgery (ABOS).

PSO (Pedicle Subtraction Osteotomy) FAQ’S

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Case Studies

He also specializes in repairing failed spine surgeries and revision spine procedures. Dr. Swiatek tailors his treatment plans to the needs of each of his patients, with a focus on non-operative management whenever possible. When surgery is necessary.

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