Short-term X-ray Results of Posterior Vertebral Column Resection in Severe Congenital Kyphosis, Scoliosis, and Kyphoscoliosis

Öztürk, Çağatay; Alanay, Ahmet; Ganiyusufoglu, Kursat; Karadereler, Selhan; Ulusoy, Levent; Hamzaoğlu, Azmi

doi:10.1097/brs.0b013e31823b4142

Cited by 53 publications

(41 citation statements)

References 19 publications

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“…Seven studies were excluded for insufficient number of patients (less than 10 patients) and one study was excluded due to the fact that the ''modified PVCR'' was performed. Seventeen studies from seven institutions [7,[9][10][11][13][14][15][16][17][18][19][20][21][22][23][24][25] were included for further analysis. To avoid overlap of patients in different studies, only one main publication from each institution was retained.…”

Section: Resultsmentioning

confidence: 99%

Posterior vertebral column resection in spinal deformity: a systematic review

Yang

Zheng²,

Liu³

et al. 2015

Eur Spine J

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Section: Resultsmentioning

confidence: 99%

Posterior vertebral column resection in spinal deformity: a systematic review

Yang

Zheng²,

Liu³

et al. 2015

Eur Spine J

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“…9). It can be performed using either combined anterior and posterior approaches or a posterior-only approach [2,3,5,7,23,24]. VCR was first described in 1922 by MacLennan [25] as a combined anterior and posterior procedure.…”

Section: Vertebral Column Resectionmentioning

confidence: 99%

Osteotomies/spinal column resections in adult deformity

et al. 2012

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Osteotomies may be life saving procedures for patients with rigid severe spinal deformity. Several different types of osteotomies have been defined by several authors. To correct and provide a balanced spine with reasonable amount of correction is the ultimate goal in deformity correction by osteotomies. Selection of osteotomy is decided by careful preoperative assessment of the patient and deformity and the amount of correction needed to have a balanced spine. Patient's general medical status and surgeon's experience levels are the other factors for determining the ideal osteotomy type. There are different osteotomy options for correcting deformities, including the Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO), bone-disc-bone osteotomy (BDBO) and vertebral column resection (VCR) providing correction of the sagittal and multiplanar deformity. SPO refers to a posterior column osteotomy in which the posterior ligaments and facet joints are removed and a mobile anterior disc is required for correction. PSO is performed by removing the posterior elements and both pedicles, decancellating vertebral body, and closure of the osteotomy by hinging on the anterior cortex. BDBO is an osteotomy that aims to resect the disc with its adjacent endplate(s) in deformities with the disc space as the apex or center of rotational axis (CORA). VCR provides the greatest amount of correction among other osteotomy types with complete resection of one or more vertebral segments with posterior elements and entire vertebral body including adjacent discs. It is also important to understand sagittal imbalance and the surgeon must consider global spino-pelvic alignment for satisfactory long-term results. Vertebral osteotomies are technically challenging but effective procedures for the correction of severe adult deformity and should be performed by experienced surgeons to prevent catastrophic complications.

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“…[15] Posterior spinal osteotomy procedures, such as Smith Peterson, Ponte, and pedicle subtraction osteotomy (PSO) may not yield a great amount of deformity correction in very severe spinal deformity cases. [15,16] The vertebral column resection (VCR) technique may provide an effective option to correct these severe and rigid spinal deformities with limited flexibility. The conventional VCR procedure can be performed by 2-stage anterior and posterior vertebral column resection, fusion, and segmental spinal instrumentation.…”

Section: Introductionmentioning

confidence: 99%

Posterior-only vertebral column resection for revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia

Tao¹,

Wu²,

Ma³

2017

Medicine

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Rationale:Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure.Patient concerns and diagnoses:The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia. He underwent posterior total laminectomy through the thoracic spine for intramedullary spinal cord tumors at the age of 3 years in another hospital. He then developed kyphosis deformity 1 year after laminectomy, and underwent posterior spinal fusion without instrumentation at 9 years of age. However, the deformity gradually progressed over the years. Seven months before admission to our hospital, he developed a significant progression of neurological deficits, including weakness of strength and sensation in lower extremities bilaterally, with no bladder or bowel dysfunction. There was no improvement of spinal cord function with conservative measures, and he required a wheelchair for movement.Interventions:The patient underwent posterior-only VCR by single stage with the purposes of spinal cord decompression and spinal deformity correction.Outcomes:Postoperatively, he was transferred to the intensive care unit (ICU) and required positive pressure ventilation support to improve his respiratory condition. The child experienced cerebrospinal fluid leak (CSF) which resulted in an unplanned return to the operating room. The neurological function improved from preoperative Frankel C to Frankel D within 12 months of surgery, and recovered completely to Frankel E by 18 months. At the 24 month follow-up, the good neurological function was maintained; pulmonary function tests (PFTs) revealed improved forced vital capacity (FVC) and forced expiratory volume for 1 second (FEV1). The patient's coronal major curve and sagittal kyphosis were corrected from 70° to 21°, and 170° to 75°, respectively.Lessons:These findings demonstrated that single-stage posterior-only VCR is efficacious but challenging for revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia.

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Short-term X-ray Results of Posterior Vertebral Column Resection in Severe Congenital Kyphosis, Scoliosis, and Kyphoscoliosis

Abstract: Posterior vertebral column resection is an effective technique providing a successful correction of stiff complex congenital deformities. However, it is a technically demanding procedure, with possible risks for major complications.

Cited by 53 publications

References 19 publications

Posterior vertebral column resection in spinal deformity: a systematic review

Posterior vertebral column resection in spinal deformity: a systematic review

Osteotomies/spinal column resections in adult deformity

Posterior-only vertebral column resection for revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia

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