INTERRADICULAR BONE-DISC-BONE
OSTEOTOMY (BDBO): AN ALTERNATIVE TO
OTHER OSTEOTOMY TYPES FOR THE
CORRECTION OF THORACOLUMBAR AND
LUMBAR SPINE DEFORMITIES
Cagatay OZTURK, MD
Mehmet AYDOGAN, MD
Selhan KARADERELER, MD
Mehmet TEZER, MD
Ahmet ALANAY, MD
Azmi HAMZAOGLU, MD
Istanbul Spine Center
Florence Nightingale Hospital
Istanbul-TURKEY
PURPOSE
 To introduce and evaluate the results of interradicular
bone disc bone osteotomy.
PATIENT SAMPLE
 12 consecutive patients with thoracolumbar and lumbar
deformities managed by BDBO and having more than 2
years of follow-up were evaluated.
METHODS
 In the surgery;
 pedicle screws at least 3 levels below and 2 levels above the
planned osteotomy level.
 Wide laminectomies at the vertebrae above and below the disc
space planned to be resected.
 Then, a wedge osteotomy just below the pedicle of the upper
adjacent vertebra and a straight osteomy through the upper end
plate of the lower adjacent vertebra, including the disc tissue .
 An anterior mesh cage placed if lengthening of the anterior
column is desired.
 Then, the osteotomy side is closed
RESULTS
 Average age of patients (6M, 6F)
 Average follow-up
 Deformities included;
 kyphosis in 7 patients
 kyphoscoliosis in 5 patients.
51 (7-76) y
47 (24-89) months.
RESULTS
 Preoperative kyphosis of 24 degrees was corrected to -15
degrees of lordosis with an average of 38 degrees of
correction.
 Preoperative scoliosis of 21 degrees was corrected to 8
degrees and found to be 10 degrees at the final follow-up.
 Average number of instrumented vertebrae was 10.
 Major complications included dural tear in 4 patients.
 There was no neurological injury.
Bone-Disc-Bone Resection
30°-35°
40°
60°
MIA, 59y, F, lumbar kyphoscoliosis, B-D-B resection
44°
L2
L3
38°
L2
L3
L2
L3
MA, 56y, F, previous operation 40 years ago.
L1
CONCLUSION
 BDBO is an effective surgery providing an average of 39
degrees of correction in sagittal plane and may be an
alternative to PVCR for patients with thoracolumbar and
lumbar severe and rigid deformities, particularly if the
apex of deformity is a disc level.
THANK YOU