• World Neurosurg · Aug 2017

    The safety and efficiency of PVCR without anterior support applied in treatment of Yang's A type severe thoracic kyphoscoliosis.

    • Wen-Yuan Sui, Zi-Fang Huang, Yao-Long Deng, Heng-Wei Fan, Jing-Fan Yang, Fo-Bao Li, and Jun-Lin Yang.
    • Department of Orthopaedic Surgery, The 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
    • World Neurosurg. 2017 Aug 1; 104: 723-728.

    ObjectiveTo assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang type A severe rigid thoracic kyphoscoliosis.MethodsThe records of 27 Yang type A severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were analyzed retrospectively. Intraoperative multimodal neurophysiological monitoring was conducted in all patients. The 6 modes were somatosensory evoked potential, motor evoked potential, descending neurogenic evoked potential, spinal cord evoked potential, and electromyography (both triggered and free run). Radiographic parameters and complications were used to evaluate the clinical outcomes.ResultsPVCR without anterior support was conducted successfully in all 27 patients. Intraoperative monitoring events occurred in 3 patients (3/27); of these, 1 patient (1/27) showed postoperative spinal cord injury, but completely recovered within 9 months after the operation (Frankel level E). The number and osteotomy space of vertebrae resection were mean 1.33 levels and 3.7 cm, respectively. All cases achieved good coronal and sagittal curve correction. No implant related complications occurred until the latest follow-up. The average follow-up was 40.1 months (range, 24-59 months).ConclusionsIn this study, we found that posterior vertebral column resection (PVCR) without any anterior support with a mean 3.7 cm shortening of the spinal column is safe, if close and unyielding contact of end plates can be obtained. A comprehensive understanding of the technique and intensive intraoperative neuromonitoring is mandatory to perform these challenging and complex spine deformity correction procedures safely.Copyright © 2017 Elsevier Inc. All rights reserved.

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