• World Neurosurg · Jun 2020

    Radiological Outcomes and Complication Analysis of the Posterior Vertebral Column Resection in the Treatment of Previously Operated Severe Kyphoscoliosis: A Retrospective Case Series.

    • Yunus Atıcı, Barış Polat, Sinan Erdoğan, Engin Çarkçı, Ayşe Esin Polat, Serdar Demiröz, and İsmet Teoman Benli.
    • Department of Orthopedic Surgery, Medical Park Gebze Hospital, Gebze, Kocaeli, Turkey.
    • World Neurosurg. 2020 Jun 1; 138: e690-e697.

    ObjectiveThe aim of this study was to evaluate the radiologic outcomes and complication analysis of posterior vertebral column resection (PVCR) performed on previously operated patients with severe kyphoscoliosis (SK).MethodsTwelve patients (6 men and 6 women) with SK underwent PVCR. The mean age of the patients preoperatively was 16 years (range, 10-26 years). The mean follow-up period was 5.3 years (range, 2-7 years). Previous surgeries included posterior growth arrest in 3 patients, hemivertebrectomy in 4 patients, and posterior fusion in 5 patients. The sagittal plane parameters and coronal parameters were measured in the preoperative, in the early postoperative, and during the last follow-up stages. Complications were also noted.ResultsThe mean thoracic scoliosis Cobb angle was 76.8° (range, 35°-142°) preoperatively, 37.8° (range, 5°-80°) early postoperatively, and 41.5° (range, 11°-80°) during the last follow-up (P < 0.0001). The mean thoracic kyphosis angle was 84.7° (range, 23°-132°) preoperatively, 50.3° (range, 25°-78°) early postoperatively, and 48.5° (range, 25°-80°) during the last follow-up (P = 0.0032). Complications occurred in 5 patients (41.7%); a hemothorax in 1 patient, rod fracture in 3 patients, and permanent neurologic deficit in 1 patient. Temporary loss of neuromonitoring motor evoked potentials developed in 2 patients during deformity correction.ConclusionsPVCR provides effective correction in patients with SK. However, expected surgical correction of a deformity may not always be achieved because of intraoperative neuromonitoring changes. Furthermore, PVCR can lead to a large number of major complications in patients with SK who have undergone previous spinal surgery.Copyright © 2020 Elsevier Inc. All rights reserved.

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