• Zhonghua Wai Ke Za Zhi · Nov 2010

    [Complications of one stage posterior vertebral column resection for the treatment of severe rigid spinal deformities].

    • Guo-Hua Lü, Xiao-Bin Wang, Bing Wang, Jing Li, Yi-Jun Kang, You-Wen Deng, and Wei-Dong Liu.
    • Department of Spinal Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China. xylgh1031@yahoo.com.cn
    • Zhonghua Wai Ke Za Zhi. 2010 Nov 15;48(22):1709-13.

    Objectiveto summarize the complications of posterior vertebral column resection (pVCR) and pedicle screw fixation for the treatment of rigid thoracic and lumber spinal deformity.Methodsfifty four patients from a single center from February 2000 to February 2009 were included in this study. There were 23 males and 31 females with an average age of 28.3 years (range, 16-58 years). Patients were divided into 4 diagnostic categories: severe scoliosis (n = 9, mean Cobb angle, 91.7°), kyphoscoliosis (n = 22, mean scoliosis, 101.5°, and mean kyphosis, 69.4°), angular kyphosis (n = 21, mean kyphosis, 72.2°), global kyphosis (n = 2, mean kyphosis, 93.6°). All of the patients received one stage pVCR combined correction with pedicle screws and circumferential fusion. Radiographs and hospital charts were reviewed to analyze the outcomes of correction.Resultsa mean of 1.4 vertebral levels were resected, the mean operative time was 470 min, and the mean blood loss was 4180 ml. All the patients were followed-up for an average time of 26 months (range, 12 - 66 months). At the latest follow-up, the major curve correction averaged: severe scoliosis 61.4° (67%), kyphoscoliosis 59.7° (56%)/kyphosis 42.3° (59%), angular kyphosis 48.5° (71%), global kyphosis 62.7° (67%). A total of 21 complications (38.9%) occurred in 17 patients, including 5 (9.3%) neurological complications happened in early stage and one case of delayed complete paraplegic. There were 11 (20.4%) non-neurological complications happened in early stage and 5 (9.3%) cases in late stage.Conclusionsone stage posterior-only vertebral column resection can achieve satisfactory correction of severe deformities with limited flexibility. Given its technically demanding and exhausting features, its potential risk of significant complications should be paid more attention.

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