Analysis of complications following posterior vertebral column resection for the treatment of severe angular kyphosis greater than 100°

Abstract

ObjectiveThe aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°.MethodsThe medical records of 17 patients (mean age 17.9 (range, 9–27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24–64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients. The sagittal plane parameters (local kyphosis angle, lumbar lordosis, sagittal vertical axis, pelvic tilt, sacral slope and pelvic incidence) were measured in the preoperative and the early postoperative periods and during the last follow-up on the lateral radiographs.ResultsThe mean preoperative localized kyphosis angle was 121.8° (range, 101°–149°). The mean local kyphosis angle (LKA) was 71.5° at postoperatively evaluation (p < 0.05). Complications were detected in 12 patients (70.6%) with spinal shock in 4 patients, hemothorax in 3 patients, postoperative infection in 2 patients, dural laceration in 2 patients, neurological deficit in 2 patients (1 paraplegia and 1 root injury), the shifted cage in 2 patients and rod fracture in 2 patients. Neurological events occurred in six patients (35%) with temporary neurological deficit in 5 patients and permanent neurological deficit in 1 patient.ConclusionPVCR is an efficient and a successful technique for the correction of SAK. However, it can lead to a large number of major complications in SAK greater than 100°.Level of evidenceLevel IV, therapeutic study.

A Retrospective Study to Compare the Efficacy of Preoperative Halo-Gravity Traction and Postoperative Halo-Femoral Traction After Posterior Spinal Release in Corrective Surgery for Severe Kyphoscoliosis

“…However, these disadvantages were compensated for by the improved radiographic correction rates. Neurological deficits are a concern in patients with severe kyphoscoliosis undergoing three-column osteotomy, with the rates for this complication having been reported to range from approximately 8.5-35% [16][17][18][19][20] . In the present study, no neurological complications were observed in the two study groups.…”

Beneficial Effects of Surgical Treatment of Compressive Myelopathy in Patients With Severe Angular Kyphosis of Thoracolumbar Spine: A Retrospective Study of 12 Cases

“…Neurological events occurred in 6 patients (35%) which were temporary in 5 patients and permanent in the other one. They concluded that although PVCR is an efficient technique for the correction of severe angular kyphosis, it is associated with several major complications [16].…”

Cifoescoliosis severa secundaria a neurofibromatosis. Presentación de un caso

“…El tiempo promedio de esta cirugía es de 6.6-9 h, con una pérdida sanguínea estimada de 1600-2280 cm 3 . 13,16 Las complicaciones por este tipo de osteotomías varían del 58,5% al 70,6%. 13,16 Auerbach y cols.…”

“…13,16 Las complicaciones por este tipo de osteotomías varían del 58,5% al 70,6%. 13,16 Auerbach y cols. 17 identifican tres factores de riesgo para sufrir una complicación mayor: balance sagital >40 mm, edad >60 años y presencia de tres o más comorbilidades, también un tiempo quirúrgico >8 h tuvo una asociación significativa.…”