posterior vertebral column resection in complex spinal disorders

Abstract

Sagittal imbalance is a major disability that should be addressed. Patient may present with a wide range of complains starting from cosmetic disfigurement and pain, up to neurological and pulmonary manifestations. This study emphasize on the importance of appropriate patient selection for successfully using this technique to accomplish satisfactory results and the extreme carful balancing between risk and benefit for patients undergoing this procedure. It is mandatory that the chosen surgical technique should match the requirements of the pathology and the patient’s metabolic capacities. Posterior vertebral column resection is an extremely technically demanding procedure with high possibility of multiple complications. However, this study demonstrates that PVCR is a relatively safe procedure when done by experienced surgeons in achieving acceptable correction for severe rigid spinal deformity not amenable to correction by other osteotomies. 35 patients (17 males/18 females) with rigid spinal deformities at our institution underwent PVCR of those 19 were kyphosis cases and 16 were kyphoscoliosis. The diagnoses included 22 congenital, 5 post traumatic, 4 post infectious and 4 neuromuscular cases. Preoperative and postoperative radiographic evaluation was performed. Intraoperative and postoperative complications were noted. For kyphosis cases an average of 1.57 vertebrae was resected (range, 1–3 vertebrae). The mean preoperative kyphosis was 68.9°, and the mean kyphosis postoperatively was 24.5° with an averag