Effectiveness and safety of one stage posterior vertebral column resection in the treatment of severe rigid kyphoscoliosis
ZHAO Yang-yang
XIE Yan-chun
ZHANG Hao-cong
XUAN An-wu
LI Zhuo
SUN Peng-fei
YU Hai-long
Abstract：Objective To evaluate the safety and clinical outcomes of vertebral column resection in the treatment of severe rigid kyphoscoliosis. Methods A total of 13 patients with severe rigid kyphoscoliosis underwent posterior vertebral column resection from September 2010 to September 2016. There were 9 females and 4 males with an average age of 16.1 years ( range: 12 - 18 years ). All the radiographic parameters were measured preoperatively, post-operatively. Pre-operative Bending Cobb's angle, Cobb's angle, the distance between C7 plumbline and center sacral vertical line ( C7PL-CSVL ), global kyphosis ( GK ), sagittal vertical axis ( SVA ), the SRS-22, VAS, SF-36 were evaluated pre-operation and post-operation. Results All the patients were followed up for an average of 12 months ( range: 6 - 24 months ). The operation lasted 240 - 580 min ( mean: 426.8 ± 86.2 min ). The mean blood loss was ( 6086.0 ± 3024.6 ) ml ( range: 1500 - 11000 ml ). The pre-operative Cobb's angle, GK angle, the spinal average flexibility, C7PL-CSVL, SVA were ( 95.6 ± 10.1 ) °, ( 103.6 ± 16.8 ) °, ( 26.2 ± 4.3 ) %, ( 62.4 ± 11.3 ) mm, ( 54.6 ± 26.2 ) mm. The post-operative Cobb's angle, GK angle, C7PL-CSVL, SVA were ( 29.2 ± 7.7 ) °, ( 28.1 ± 10.4 ) °, ( 18.8 ± 6.2 ) mm, ( 28.1 ± 10.8 ) mm. There were significant differences between the 2 groups ( P < 0.05 ). At the latest follow-up, Cobb's angle, GK angle, C7PL-CSVL, SVA were ( 31.1 ± 10.1 ) °, ( 29.3 ± 4.0 ) °, ( 21.9 ± 4.6 ) mm, ( 32.1 ± 6.7 ) mm. Intraoperative electrophysiological monitoring of somatosensory evoked potential ( SEP ) and motor evoked potentials ( MEP ) showed no changes. Postoperatively, 1 case had left hemothorax, 4 cases had lower extremity sensory dysfunction, 2 cases had pedicle screw malposition. SRS-22, VAS, SF-36 improved significantly after surgery ( P < 0.05 ). Conclusions One stage posterior vertebral column resection is safe and effective in the treatment of severe and rigid thoracolumbar kyphoscoliosis. It can achieve satisfactory correction and improve patients' life quality. However, attention should be paid to avoid complications.
Keywords：KyphosisSurgical proceduresoperativeThoracic vertebraeLumbar vertebrae
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 417-422 )