AO Spine Course—Deformity: Advanced Techniques and Complex Cases
This two-day interactive course delves into advanced surgical techniques for managing complex spinal deformities. Through a combination of online pre-learning, case-based discussions, and hands-on practical exercises, participants will gain:
- In-depth knowledge of complex conditions in adult and pediatric deformities
- Advanced surgical skills through hands-on practice using real instruments and implants
- Enhanced clinical decision-making via collaborative analysis of real-world cases, focusing on patient evaluation, surgical planning, and complication management.
Participants will learn, apply, and ultimately master the competencies required for complex deformity management.
Why choose this course?
World-class curriculum
Developed by leading global experts
Expert faculty
Learn from renowned regional specialists
Hands-on experience
2 days in duration
Network
Build valuable professional connections
Course content
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Online pre-learning
4 weeks before the course, you will get access to a short online pre-learning module, which includes short video lectures, practical exercises videos, and articles on:
- Clinical evaluation of patients with adult deformity
- Principles of sagittal alignment and compensatory mechanisms
- PCO technique
- Determination of instrumentation levels in AIS
- The Lenke AdIS classification and its application to surgical planning
- PSO technique in the lumbar spine
- The Roussouly classification and its application to treatment of patients with deformity
- Imaging evaluation in adult deformity
- PSO technique in the thoracic spine
- Iliosacral fixation
- Guide for surgical planning
- Frailty and surgical risk and outcomes in adult deformity
- PVCR technique
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Course modules
- Adolescent idiopathic scoliosis – advanced skills
- Intraoperative neuromonitoring (IONM)
- Adult idiopathic scoliosis
- Adult spine deformity: sagittal and coronal balance
- High-grade spondylolisthesis
- Anterior surgery in adult deformity*
- Navigation in deformity surgery*
- Sagittal deformities of the cervical spine*
*Only in selected courses. Please check the final course program.
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Case-based discussions
Analyse real-world clinical cases with fellow participants and faculty to enhance clinical decision-making and problem-solving skills:
- Severe kyphoscoliosis (PVCR case)
- Revision problems in sagittal imbalance in patients with a fused spine
- High grade isthmic spondylolisthesis*
*In selected courses. Please check the final course program.
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Case-based exercises
Activity where participants are given specific tasks or clinical challenges to solve. It promotes active learning by requiring applying theoretical knowledge and practical experience to real-world cases, with expert feedback guiding their approach.
- Selective Thoracic Fusion in Lenke 1C or 3C pattern
- Distal instrumented level in Lenke 3 or 4 patterns
- Neuromonitoring game “Losing the signals”
- Treatment of idiopathic scoliosis in a young adult (>35) patient
- Treatment of idiopathic scoliosis in elderly adult
- Use of electronic tools and “flight plan” template to prepare and predict surgical outcomes
*In selected courses. Please check the final course program.
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Lectures
The course covers short, evidence-based lectures on the following topics:
- Criteria for successful selective thoracic fusion in Lenke 1C or 3C patterns
- Criteria to select L4 vs L3 in Lenke 3 or 4 patterns
- PVCR: When it is needed, what are the alternatives, and how to perform it safely
- IONM: Intraoperative alerts: What is an alert, how to address it
- Application of the AdIS classification: Selection of fusion levels based on standing and supine full-spine radiographs
- Lower lumbar versus sacropelvic distal fixation in AdIS
- Alignment drivers of outcomes in ASD with imbalance
- Surgical options in operated deformity with residual imbalance
- Indications for reduction in high grade isthmic spondylolisthesis*
*In selected courses. Please check the final course program.
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Hands-on practical exercises
Step-by-step practical exercises are performed either on synthetic models featuring real deformities or on human anatomical specimens, depending on the course location. Please refer to the course program for final details.
1. Posterior vertebral column resection for severe thoracic deformity
- Posterior fixation with pedicle screws T2 to T8 using anatomical references
- Step by step posterior vertebrectomy
- Decide and implement the size of the cage and safe cage implantation and control of its stability
- Correction of the deformity with temporary rods and vertebral body replacement cage
- Demonstrate different methods of correction – 1. Progressive rod contouring and compression 2. Multiple persuaders on one side to reduce progressively and 3. Domino technique
2. Correction of coronal and sagittal imbalance in the fused lumbar spine.
- Posterior fixation with pedicle screws T11 to S1 using anatomical references
- Iliac fixation (iliac and S2I screws)
- Pedicle subtraction osteotomy in the lumbar spine
- Fine tuning of correction in the coronal and sagittal planes using cantilever, multiple persuaders, domino technique, and kickstand rods
- Demonstrate different configurations of multirod: 1. Deep short rod (Gupta), 2. Delta rod (Delta), 3. Parallel rod
- Discuss continuity of the posterior column
3. Anterior surgery*
4. Navigation in deformity surgery*
5. Sagittal deformities of the cervical spine*
*In selected courses. Please check the final course program.
Who should attend
- Spine surgeons who treat deformity cases and who face more complex cases
- Surgeons who want to update their treatment of complex idiopathic and adult deformity.
- It is also suitable for surgeons who have attended the “Deformity: Key Concepts and Techniques” course and/or Global Spine Diploma and want to increase their knowledge and skills.

“The course curriculum is designed to deliver the learning through an active experience: active discussions based on real cases, interactive exercises that apply the knowledge from those cases, and step-by-step hands-on practical sessions. This way, we ensure that learners not only acquire the information but also know how to apply it. The experience of the faculty, the professionalism of the support team, and the peer-to-peer, friendly training tradition of AO make all the difference. It is an experience that will leave a lasting impression.”
Pedro Berjano
Chairperson AO Spine Europe and Southern Africa
Chair of Deformity Curriculum Taskforce
After the course you master the following competencies:
- Perform a history, clinical, and physical examination in complex cases in adults and pediatric patients with deformity
- Order and interpret imaging and investigations to classify complex pathologies and deformities
- Plan surgical correction appropriate for complex and revision cases, and recognize the benefit of preoperative medical optimization
- Perform correction maneuvers for severe curves, sagittal imbalance, and revision surgery (multirod constructs, sacropelvic fixation, osteotomies, etc)
- Avoid and manage complications, including PJK prevention strategies and managing late rod complications
- Recognize the role of emerging technologies such as augmentation and biologics and latest research findings and evidence in clinical practice
AO Spine Deformity Curriculum Task Force
The Deformity Curriculum taskforce is a group of experts who build and continuously improve our educational program.

Pedro Berjano
Italy
Chair of the Taskforce
Representing Europe and Southern Africa

Luis Eduardo Carelli
Brazil
Representing Latin America

Eric Klineberg
US
Representing North America

Omar Alnori
Qatar
Representing Middle East and Northern Africa

Yong Hai
China
Representing Asia Pacific

Alpaslan Senkoylu
Representing
AO In-Hospital

Evan Davies
Representing
Global Spine Diploma

Michael Kelly
Representing
Knowledge Forum Deformity

Richard Bransford
AO Spine Education Commission Chairperson

Bryan Ashman
AO Spine Curriculum Advisor