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Posterior vertebral column resection for severe spinal deformities.
Spine (Phila Pa 1976). 2002 Nov 01; 27(21):2374-82.S

Abstract

STUDY DESIGN

Retrospective study.

OBJECTIVES

To report a technique of vertebral column resection through a single posterior approach and its preliminary results in the treatment of moderate to severe spinal deformities with limited flexibility.

SUMMARY OF BACKGROUND DATA

Vertebral column resection is a formidable operation reserved for moderate to severe deformities with limited flexibility. The authors devised a technique of vertebral column resection through a single posterior approach that offers significant advantages over the anterior-posterior vertebral column resection.

METHODS

Seventy spinal deformity patients treated by posterior vertebral column resection were reviewed. Minimum follow-up was 2 years (range 2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years at the time of the operation. Etiologic diagnoses were adult scoliosis in 7, congenital kyphoscoliosis in 38, and postinfectious kyphosis in 25. The surgery consisted of temporary stabilization of the vertebral column with segmental pedicle screw fixation, resection of the vertebral column at the apex of the deformity via the posterior route, followed by gradual deformity correction and global fusion.

RESULTS

The total number of resected vertebrae was 143: 76 in thoracic and 67 in lumbar. Mean operation time was 4 hours, 31 minutes with average blood loss of 2333 mL. The deformity correction was 61.9% in the coronal plane and 45.2 degrees in the sagittal plane. Complications were encountered in 24 patients: 2 complete cord injuries in severe adult scoliosis and thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections, and 5 hemopneumothoraxes.

CONCLUSIONS

Posterior vertebral column resection is an effective alternative for moderate to severe deformities with limited flexibility. However, it is a technically demanding and exhausting procedure with possible risks for major complications.

Authors+Show Affiliations

Seoul Spine Institute, Inje University Sanggye Paik Hospital, Seoul, Korea. seilsuk@unitel.co.krNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12438987

Citation

Suk, Se-Il, et al. "Posterior Vertebral Column Resection for Severe Spinal Deformities." Spine, vol. 27, no. 21, 2002, pp. 2374-82.
Suk SI, Kim JH, Kim WJ, et al. Posterior vertebral column resection for severe spinal deformities. Spine (Phila Pa 1976). 2002;27(21):2374-82.
Suk, S. I., Kim, J. H., Kim, W. J., Lee, S. M., Chung, E. R., & Nah, K. H. (2002). Posterior vertebral column resection for severe spinal deformities. Spine, 27(21), 2374-82.
Suk SI, et al. Posterior Vertebral Column Resection for Severe Spinal Deformities. Spine (Phila Pa 1976). 2002 Nov 1;27(21):2374-82. PubMed PMID: 12438987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior vertebral column resection for severe spinal deformities. AU - Suk,Se-Il, AU - Kim,Jin-Hyok, AU - Kim,Won-Joong, AU - Lee,Sang-Min, AU - Chung,Ewy-Ryong, AU - Nah,Ki-Ho, PY - 2002/11/20/pubmed PY - 2003/1/14/medline PY - 2002/11/20/entrez SP - 2374 EP - 82 JF - Spine JO - Spine (Phila Pa 1976) VL - 27 IS - 21 N2 - STUDY DESIGN: Retrospective study. OBJECTIVES: To report a technique of vertebral column resection through a single posterior approach and its preliminary results in the treatment of moderate to severe spinal deformities with limited flexibility. SUMMARY OF BACKGROUND DATA: Vertebral column resection is a formidable operation reserved for moderate to severe deformities with limited flexibility. The authors devised a technique of vertebral column resection through a single posterior approach that offers significant advantages over the anterior-posterior vertebral column resection. METHODS: Seventy spinal deformity patients treated by posterior vertebral column resection were reviewed. Minimum follow-up was 2 years (range 2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years at the time of the operation. Etiologic diagnoses were adult scoliosis in 7, congenital kyphoscoliosis in 38, and postinfectious kyphosis in 25. The surgery consisted of temporary stabilization of the vertebral column with segmental pedicle screw fixation, resection of the vertebral column at the apex of the deformity via the posterior route, followed by gradual deformity correction and global fusion. RESULTS: The total number of resected vertebrae was 143: 76 in thoracic and 67 in lumbar. Mean operation time was 4 hours, 31 minutes with average blood loss of 2333 mL. The deformity correction was 61.9% in the coronal plane and 45.2 degrees in the sagittal plane. Complications were encountered in 24 patients: 2 complete cord injuries in severe adult scoliosis and thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections, and 5 hemopneumothoraxes. CONCLUSIONS: Posterior vertebral column resection is an effective alternative for moderate to severe deformities with limited flexibility. However, it is a technically demanding and exhausting procedure with possible risks for major complications. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/12438987/Posterior_vertebral_column_resection_for_severe_spinal_deformities_ L2 - https://doi.org/10.1097/00007632-200211010-00012 DB - PRIME DP - Unbound Medicine ER -