Posterior vertebral column resection for severe rigid scoliosis

• Published in: Spine (Philadelphia, Pa. 1976) Vol. 30; no. 14; p. 1682
• Main Authors: Suk, Se-Il, Chung, Ewy-Ryong, Kim, Jin-Hyok, Kim, Sung-Soo, Lee, Jung-Sub, Choi, Won-Kee
• Format: Journal Article
• Language: English
• Published: United States 15.07.2005
• Subjects: Adult; Female; Follow-Up Studies; Humans; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Male; Postoperative Complications - prevention & control; Radiography; Retrospective Studies; Scoliosis - diagnostic imaging; Scoliosis - surgery; Severity of Illness Index; Spinal Fusion - instrumentation; Spinal Fusion - methods; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - surgery; Treatment Outcome
• DOI: 10.1097/01.brs.0000170590.21071.c1

Retrospective study. To report on the technique and results of posterior vertebral column resection (PVCR) for severe rigid scoliosis. The treatment of severe rigid scoliosis is a demanding surgical challenge. Conventional procedures such as combined anteroposterior instrumentation enable limited correction. In rigid scoliosis, vertebral column resection is a better option for accomplishing translation of spinal column. PVCR is performed through a single posterior approach. A total of 16 patients with scoliosis (average age 29 years) subjected to PVCR were retrospectively reviewed after a minimum follow-up of 2 years (range 2-6.8). The indication for PVCR was scoliosis more than 80 degrees , with flexibility less than 25%. The radiographic parameters were evaluated, and clinical records were reviewed. The number of vertebrae removed averaged 1.3, and 21 total (15 thoracic and 6 lumbar). Average fusion extent was 10.6 vertebrae. The mean preoperative scoliosis of 109.0 degrees was corrected to 45.6 degrees (59% correction) at the most recent follow-up, and the minor curve of 59.3 degrees was corrected to 29.2 degrees (51% correction). The mean preoperative coronal imbalance of 4.0 cm was improved to 1.0 cm at the most recent follow-up, and sagittal imbalance of 4.2 cm was improved to 1.6 cm. Complications were encountered in 4 patients, including 1 complete paralysis, 1 hematoma, 1 hemopneumothorax, and 1 proximal junctional kyphosis. PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.