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The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis

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Abstract

Purpose

The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis.

Methods

24 patients with isolated angular congenital kyphosis treated by PVCR in our hospital were retrospectively studied. The patients’ radiographs and hospital records were reviewed. Deformity in sagittal planes and global sagittal alignment were analyzed for correction and maintenance of the correction in preoperative, postoperative, and follow-up radiographs. The complications and related risk factors were analyzed.

Results

The average age was 13.9 (4–40) years. Three of them were revision surgeries. Two patients have intraspinal anomalies. The mean follow-up is 56.9 (26–129) months. The mean operation time was 293.1 (170–480) min. The averaged blood loss was 993.8 (250–3000) ml. The segmental kyphosis was 87.3° before surgery, 17.6° post surgery and 20.4° at the latest the follow-up. And the sagittal vertical axis was improved from 43.1 mm to 9.2 mm. Mean total score of SRS-22 was 89.3. Complications occurred in 4 patients, including 1 screw pullout due to pseudarthrosis, 1 proximal junctional kyphosis, 1 incomplete spinal cord injury and 1 root injuries.

Conclusion

Posterior-only vertebral column resection is an ideal procedure for severe rigid congenital kyphosis. However, it is still a highly technical demanding procedure. Neurological compromises still remain the biggest challenges. Sufficient height of anterior reconstruction, avoidance sacrifice of bilateral roots in the same level in the thoracic spine, avoidance of the sagittal translation of the upper and lower vertebras, intra-operative neuromonitoring, and preoperative surgical release of diastematomyelia and tethered cord may help to improve the safety.

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References

  1. McMaster MJ, Singh H (1999) Natural history of congenital kyphosis and kyphoscoliosis. A study of one hundred and twelve patients. J Bone Joint Surg Am 81:1367–1383

    Article  CAS  PubMed  Google Scholar 

  2. Winter RB, Moe JH, Wang JF (1973) Congenital kyphosis. Its natural history and treatment as observed in a study of one hundred and thirty patients. J Bone Joint Surg Am 55:223–256

    Article  CAS  PubMed  Google Scholar 

  3. Kim YJ, Otsuka NY, Flynn JM et al (2001) Surgical treatment of congenital kyphosis. Spine 26(20):2251–2257

    Article  CAS  PubMed  Google Scholar 

  4. Zeng Y, Chen ZQ, Qi Q et al (2013) The posterior surgical correction of congenital kyphosis and kyphoscoliosis: 23 cases with minimum 2 years follow-up. Eur Spine J 22:372–378

    Article  PubMed  Google Scholar 

  5. Yunus Atici, Sokucu S, Uzumcugil O et al (2013) The results of closing wedge osteotomy with posterior instrumented fusion for the surgical treatment of congenital kyphosis. Eur Spine J 22(6):1368–1374

    Article  Google Scholar 

  6. Suk SI, Kim JH, Kim WJ et al (2002) Posterior vertebral column resection for severe spinal deformities. Spine 27:2374–2382

    Article  PubMed  Google Scholar 

  7. Lenke LG, O’Leary PT, Bridwell KH (2009) Posterior vertebral column resection for severe pediatric deformity. Spine 34(20):2213–2221

    Article  PubMed  Google Scholar 

  8. Hamzaoglu A, Alanay A, Ozturk C et al (2011) Posterior vertebral column resection in severe spinal deformities. Spine 36:E340–E344

    Article  PubMed  Google Scholar 

  9. Papadopoulos E, Boachie-Adjei O, Hess WF et al (2013) Early outcomes and complications of posterior vertebral column resection. Spine J 15:983–991

    Article  PubMed  Google Scholar 

  10. Noordeen MHH, Garrido E, Tucker SK et al (2009) The surgical treatment of congenital kyphosis. Spine 34(17):1808–1814

    Article  CAS  PubMed  Google Scholar 

  11. Ayvaz M, Olgun ZD, Dimirkiran HG et al (2014) Posterior all-pedicle screw instrumentation combined with multiple chevron and concave rib osteotomies in the treatment of adolescent congenital kyphoscoliosis. Spine J 14:11–19

    Article  PubMed  Google Scholar 

  12. Wang Y, Zhang Y, Zhang X et al (2008) A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases. Eur Spine J 17:361–372

    Article  PubMed  PubMed Central  Google Scholar 

  13. Leatherman KD, Dickson RA (1979) Two-stage corrective surgery for congenital deformities of the spine. J Bone Joint Surg Br 61:324–328

    PubMed  Google Scholar 

  14. Bradford DS (1987) Vertebral column resection. Printed abstract from the Association of Bone and Joint Surgeons Annual Meeting. Orthop Trans 11:502

    Google Scholar 

  15. Boachie-Adjei O, Bradford DS (1991) Vertebral column resection and arthrodesis for complex spinal deformities. J Spinal Disord 4:193–202

    Article  CAS  PubMed  Google Scholar 

  16. Suk SI, Chung ER, Kim JH et al (2005) Posterior vertebral column resection for severe rigid scoliosis. Spine 30:1682–1687

    Article  PubMed  Google Scholar 

  17. Xie JM, Zhang Y, Wang YS et al (2014) The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities. Eur Spine J 23:149–156

    Article  PubMed  Google Scholar 

  18. Hui H, Zhang ZX, Yang TM et al (2014) Vertebral column resection for complex congenital kyphoscoliosis and type I split spinal cord malformation. Eur Spine J 23:1158–1163

    Article  PubMed  Google Scholar 

  19. Jeszenszky D, Haschtmann D, Kleinstuck FS et al (2014) Posterior vertebral column resection in early onset spinal deformities. Eur Spine J 23:198–208

    Article  CAS  PubMed  Google Scholar 

  20. Zeng Y, Chen Z, Guo Z et al (2013) Complications of correction for focal kyphosis after posterior osteotomy and the corresponding management. J Spinal Disord Tech 26(7):367–374

    Article  PubMed  Google Scholar 

  21. O’Shaughnessy BA, Koski TR, Ondra SL (2008) Reversal of neurological deterioration after vertebral column resection by spinal cord untethering and duraplasty. Spine 32:E50–E54

    Article  Google Scholar 

  22. Spiro AS, Rupprecht M, Stenger P et al (2013) Surgical treatment of severe congenital thoracolumbar kyphosis through a single posterior approach. Bone Jt J 95-B(11):1527–1532

    Article  CAS  Google Scholar 

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Acknowledgements

IRB approval statement: This study has been approved from the Institutional Review Board. This work was supported by the National Natural Science Foundation of China (81171673).

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    Authors and Affiliations

    1. Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China

      Shengru Wang, Jianguo Zhang, Guixing Qiu, Jianwei Guo, Yanbin Zhang & Xisheng Weng

    2. Department of Spine Surgery of Traditional Chinese Hospital Affiliated To Xinjiang Medical University, Urumqi, 830000, China

      Kahaer Aikenmu

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    1. Shengru Wang
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    Correspondence to Jianguo Zhang.

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    S. Wang and J. Guo contributed equally to this paper.

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    Wang, S., Aikenmu, K., Zhang, J. et al. The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis. Eur Spine J 26, 1817–1825 (2017). https://doi.org/10.1007/s00586-015-4344-9

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    • DOI: https://doi.org/10.1007/s00586-015-4344-9

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