Perioperative complications of posterior vertebral column resection for patients with severe angular kyphosis

CHEN Zhi-ming; MA Hua-song; TAN Rong; WU Ji-gong; WANG Xiao-ping; YUAN Wei; XU Qi-ming; ZHAO Fu-jiang

doi:10.3969/j.issn.2095-252X.2014.12.007

Abstract：Objective To analyze the perioperative complications of posterior vertebral column resection ( PVCR ) for the patients with severe angular kyphosis. Methods From January 2006 to December 2013, 38 patients with severe angular kyphosis were treated by PVCR. There were 21 males and 17 females, whose average age was 27.5 years old ( range:13-61 years ). The preoperative kyphosis angle and scoliosis angle were 116° ( range:85°-175° ) and 16° ( range: 0°-40° ) respectively. The clinical outcomes were evaluated and the perioperative complications were analyzed. Results The average operation time was 312 min ( range:210-470 min ), and the average blood loss was 2089 ml ( range:800-4500 ml ). The average follow-up time was 43.5 months ( range:6-72 months ). The mean postoperative kyphosis angle was 43.6° ( range:10°-98° ) and the correction rate was 62.4%. The mean postoperative scoliosis angle was 5.2° ( range:0°-12° ) and the correction rate was 67.5%. The total perioperative complication rate was 42.1%( 16/38 ). Neurological complications occurred in 5 patients ( 13.2%), including complete spinal cord injury ( n=1 ) and transient neurological deifcit ( n=4 ). There were 9 cases of early non-neurological complications ( 23.7%), including hemothorax ( n=2 ), dural injury ( n=2 ), loosening of pedicle screw ( n=3 ), superiifcial wound infection ( n=1 ) and gastrointestinal dysfunction ( n=1 ). The medium-term complications were noticed in 2 cases ( 5.3%), including rod breakage ( n=1 ) and kyphosis aggravation ( n=1 ). Conclusions PVCR is an effective method for severe angular kyphosis, and its potential risk of severe complications should be paid more attention.