Surgical and radiological outcomes after posterior vertebral column resection according to the surgeon's experience

Lee, Byoung Hun; Hyun, Seung-Jae; Han, Soonhung; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J.; Kim, Hyun-Jib

doi:10.1097/md.0000000000011660

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…The classification system defined type A as patients with normal spinal cord and evoked potentials and no neurological symptoms. Posterior vertebral column resection (PVCR) without anterior support applied was routinely used in our center to treat Yang's type A severe kyphoscoliosis, and similar clinical outcomes were observed as those in previous studies ( 2 – 4 ).…”

Section: Introductionsupporting

confidence: 62%

Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis

Wu¹,

Ding

Yang

et al. 2023

Front. Surg.

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BackgroundsThe incidence and characteristics of postoperative dysesthesia (POD) have not been reported for posterior vertebral column resection (PVCR) in the treatment of severe spinal kyphoscoliosis.ObjectiveThe objective of the study is to investigate the incidence and characteristics of POD in PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis.Material and methodsFrom August 2010 to December 2019, 167 patients diagnosed with Yang's type A severe spinal kyphoscoliosis who underwent PVCR without anterior support applied were retrospectively reviewed. All the patients were monitored using five modes of intraoperative multimodal neurophysiological monitoring. Neuromonitoring data, radiographic parameters, and neurological complications were reviewed and analyzed. The incidence and characteristics of POD were further summarized. POD was defined as dysesthetic pain or burning dysesthesia which could be caused by spinal cord kinking or dorsal root ganglion (DRG) injury but with no motor deficits.ResultsPVCR without anterior support was successfully conducted in all 167 patients. Intraoperative monitoring events occurred in five patients. One out of these five patients showed postoperative spinal cord injury (Frankel level C) but completely recovered within 9 months postoperation (Frankel level E). The number of levels and osteotomy space for vertebra resection were 1.28 and 3.6 cm, respectively. POD was confirmed in three patients (3/167, 1.8%), characterized as kyphosis with the apex vertebrae in T12 with the kyphotic Cobb angles of 100°, 115°, and 122°, respectively. The osteotomy space of vertebra resection in these three patients were 3.9, 3.8, and 4.2 cm, respectively. After the treatment by drug administration, they reported pain relief for 12–36 days. The pain gradually moved to the distal end of a proper DRG innervated region near the end.ConclusionsIn this study, the incidence rate of POD in Yang's type A severe spinal kyphoscoliosis patients who underwent PVCR without anterior support applied was 1.8% (3/167). Evoked potential monitoring could not detect the occurrence of POD. POD in Yang's type A severe spinal kyphoscoliosis after PVCR could be ascribed to spinal cord kinking and DRG injury.

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Section: Introductionsupporting

confidence: 62%

Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis

Wu¹,

Ding

Yang

et al. 2023

Front. Surg.

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“…However, for the patients with posttraumatic kyphosis more than 60º, there is no recommended specific surgical technique in the literature. For this reason, in our study, we evaluated patients with posttraumatic kyphosis more than 60º (18). In our study, SRS-22 scores had increased from 2.4 ± 0.3 to 4.2 ± 0.4 in the postoperative period which was statistically significant (p<0.05).…”

Section: █ Resultsmentioning

confidence: 74%

Improvement of life after pvcr in complete paraplegic patients with posttraumatic severe kyphosis

Karagüven

Benli²,

Acaroğlu³

et al. 2020

Turkish Neurosurgery

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AIM:To determine the effect of posterior vertebral column resection (PVCR) in patients with paraplegia by using the American Spinal Injury Association (ASIA) score and Scoliosis Research Society (SRS)-22 questionnaire. MATERIAL and METHODS:Twelve patients with posttraumatic paraplegia and severe angular kyphosis (>60⁰) had undergone PVCR between 6-24 months after the trauma for severe pain, persistent vertebral instability and difficulty in adherence to rehabilitation. ASIA scores and SRS-22 questionnaire results obtained in the preoperative and postoperative periods, and the last control were statistically compared to assess the presence of any change. RESULTS:The average age of twelve patients included in this study was 35.6 ± 10.2 (21-51) years. Female/male ratio was 2/10 (20.0%). The mean follow-up duration was 50.3 ± 17.6 (24-86) months. None of the patients had additional changes in neuromonitoring records during surgery. The mean preoperative kyphotic angle of the patients was 66.58° ± 7.1⁰ (60⁰-82⁰) which decreased to 7.0⁰ ± 5.4⁰ in the postoperative period (p<0.05). The mean ASIA score, which was 43.3 ± 5.1 preoperatively, increased to 44.4 ± 4.4 in the postoperative period. The SRS-22 score, which was 2.4 ± 0.3 in the preoperative period, increased to 4.2 ± 0.4 in the early postoperative period. This increase was found to be statistically significant (p<0.05). The SRS-22 score was 4.1 ± 0.4 at last follow-up and was not statistically different from the early postoperative value (p>0.05). CONCLUSION:In the light of these data, it can be stated that PVCR is a safe and reliable procedure in paraplegic patients with rigid posttraumatic kyphosis and increases patient satisfaction.

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“…Die technisch aufwändige "posterior vertebral column resection" (PVCR) ist die operative Technik, die im Vergleich zu anderen Techniken (z. B. Smith-Peterson-Osteotomie oder Pedikelsubtraktionsosteotomie) die größte Deformitätenkorrektur an der BWS ermöglicht [3]. Die Operationstechnik ist extrem anspruchsvoll und sollte daher sehr kritisch indiziert werden.…”

Section: Posterior Vertebral Column Resection (Pvcr) Zur Korrektur Vounclassified

Posterior vertebral column resection (PVCR) zur Korrektur von Hyperkyphosen bei osteoporotischen Frakturen der Brustwirbelsäule

Sehmisch

Lehmann

Dreimann

et al. 2019

Oper Orthop Traumatol

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Surgical and radiological outcomes after posterior vertebral column resection according to the surgeon's experience

Cited by 9 publications

References 24 publications

Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis

Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis

Improvement of life after pvcr in complete paraplegic patients with posttraumatic severe kyphosis

Posterior vertebral column resection (PVCR) zur Korrektur von Hyperkyphosen bei osteoporotischen Frakturen der Brustwirbelsäule

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