Abstract
Unlike adolescent scoliosis, adult spinal deformities are frequently associated with a rigid spine. The last decade has witnessed major advances in the understanding of how to treat these problems, and one of the major developments has been an increasing understanding of the need for various osteotomies to mobilize the spine prior to correction of the deformity. Destabilizing osteotomies, which remove bone in the anterior or posterior spinal columns, allow the spine to become mobile in the sagittal and/or coronal planes. This destabilization prior to reconstruction is particularly important in the setting of osteoporosis where spinal fixation can be poor and screw pullout is a major concern.