الفهرس 
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Abstract
S
mith Peterson osteotomy and pedicle subtraction osteotomy remain the most commonly used osteotomies in management of kyphosis.
SPO was preferred to avoid lengthy operations and blood loss compared to PSO. Moreover, it is one of the former osteotomies in management of kyphosis and less surgically demanding.
However, PSO on the other hand achieves more correction, Therefore less neurological complication associated with multi level correction -SPOs.
More studies still needed in this field, neither PSO nor SPO can be generalized for absolute. However, the ideal patient’s characteristic for PSO was patients with severe fixed angular deformity and high blood loss tolerance and experienced surgeon. Preoperative assessment of the deformity can help to determine which osteotomy is best suited and how much angular correction is needed. Patient’s general medical status and surgeon’s experience levels are the other factors for determining the ideal treatment.