Ahmad M. Tarawneh, Muralidharan Venkatesan, Dritan Pasku, Jagdeep Singh, Nasir A. Quraishi

December 2020, Volume 29, Issue 12, pp 2953 - 2959 Review Article Read Full Article 10.1007/s00586-020-06439-y

First Online: 07 May 2020

Study design

Systematic review and meta-analysis.


Three-column osteotomies (3-CO) have gained popularity in the last decade as part of the armamentarium for the surgical correction of sagittal imbalance in patients with adult spinal deformity (ASD). Three-column osteotomies in the form of pedicle subtraction osteotomy (PSO) may be necessary to achieve adequate correction for severe and rigid spinal deformity. Studies reporting improvement in health-related quality of life (HRQOL) with validated outcome measures after PSO surgery are sparse and currently consist of small series.


Evaluate the improvement in HRQOL measures following PSO for adult spinal deformity.


Two independent reviewers conducted a systematic review of the English literature between period 1996 and 2019 for articles reporting outcome of PSO in patients with ASD according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Inclusion criteria were studies consisting of patient-reported outcome Oswestry Disability Index (ODI) and Scoliosis Research Society 22 or 24 (SRS) outcomes after PSO surgery for adult spine deformity patients (18 years or older) with a minimum follow-up of 1 year.


Eight studies with 431 PSOs were included in the meta-analysis. The results showed a statistically significant improvement in ODI in PSO (P 


This meta-analysis did find improvements in the health-related quality of life in patients undergoing PSO surgery for adult spinal deformity.

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