Analysis of complications following posterior vertebral column resection for the treatment of severe angular kyphosis greater than 100

Objective: The aim of this study was to evaluate the complications, efŞcacy and safety of posteriorvertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100.Methods: The medical records of 17 patients (mean age 17.9 (range, 9e27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24e64) months. Diagnosis of thepatients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients andneuroŞbromatosis in 3 patients. The sagittal plane parameters (local kyphosis angle, lumbar lordosis,sagittal vertical axis, pelvic tilt, sacral slope and pelvic incidence) were measured in the preoperative andthe early postoperative periods and during the last follow-up on the lateral radiographs.Results: The mean preoperative localized kyphosis angle was 121.8(range, 101e149). The mean localkyphosis angle (LKA) was 71.5at postoperatively evaluation (p< 0.05). Complications were detected in12 patients (70.6%) with spinal shock in 4 patients, hemothorax in 3 patients, postoperative infection in 2patients, dural laceration in 2 patients, neurological deŞcit in 2 patients (1 paraplegia and 1 root injury),the shifted cage in 2 patients and rod fracture in 2 patients. Neurological events occurred in six patients(35%) with temporary neurological deŞcit in 5 patients and permanent neurological deŞcit in 1 patient.Conclusion: PVCR is an efŞcient and a successful technique for the correction of SAK. However, it can leadto a large number of major complications in SAK greater than 100.Level of evidence: Level IV, therapeutic study.

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1. Albayrak A, Balioglu MB, Misir A, et al. Preoperative and postoperative photographs and surgical outcomes of patients with kyphosis. Spine. 2016 Oct 1;41(19):E1185eE1190. http://dx.doi.org/10.1097/BRS.0000000000001573.

2. Konstam PG, Blesovsky A. The ambulant treatment of spinal tuberculosis. Br J Surg. 1962 Jul;50(219):26e38. http://dx.doi.org/10.1002/bjs.18005021908.

3. Cho WJ, Kang CN, Park YS, Kim HJ, Cho JL. Surgical correction of fixed kyphosis. Asian Spine J. 2007 Jun;1(1):12e18. http://dx.doi.org/10.4184/asj.2007.1.1.12.

4. MacLennan A. Scoliosis. Br Med J. 1922;2:865e866.

5. Bradford DS. Vertebral column resection. Orthop Trans. 1987;11:502.

6. Boachie-Adjei O, Bradford DS. Vertebral column resection and arthrodesis for complex spinal deformities. J Spinal Disord. 1991 Jun;4(2):193e202.

7. Suk SI, Kim JH, Kim WJ, Lee SM, Chung ER, Nah KH. Posterior vertebral column resection for severe spinal deformities. Spine. 2002 Nov 1;27(21):2374e2382. http://dx.doi.org/10.1097/01.BRS.0000032026.72156.1D.

8. Lenke LG, Sides BA, Koester LA, Hensley M, Blanke KM. Vertebral column resection for the treatment of severe spinal deformity. Clin Orthop Relat Res. 2010 Mar;468(3):687e699. http://dx.doi.org/10.1007/s11999-009-1037-x.

9. Ozturk C, Alanay A, Ganiyusufoglu K, Karadereler S, Ulusoy L, Hamzaoglu A. Short-term X-ray results of posterior vertebral column resection in severe congenital kyphosis, scoliosis, and kyphoscoliosis. Spine. 2012 May 20;37(12): 1054e1057. http://dx.doi.org/10.1097/BRS.0b013e31823b4142

10. Sponseller PD, Jain A, Lenke LG, et al. Vertebral column resection in children with neuromuscular spine deformity. Spine. 2012 May 15;37(11):E655eE661. http://dx.doi.org/10.1097/BRS.0b013e318244460d.

11. Xie J, Wang Y, Zhao Z, et al. Posterior vertebral column resection for correction of rigid spinal deformity curves greater than 100. J Neurosurg Spine. 2012 Dec;17(6):540e551. http://dx.doi.org/10.3171/2012.9.SPINE111026.

12. Lenke LG, Newton PO, Sucato DJ, et al. Complications after 147 consecutive vertebral column resections for severe pediatric spinal deformity: a multicenter analysis. Spine. 2013 Jan 15;38(2):119e132. http://dx.doi.org/10.1097/ BRS.0b013e318269fab1.

13. Wang XB, Lenke LG, Thuet E, Blanke K, Koester LA, Roth M. The deformity angular ratio describes the severity of spinal deformity and predicts the risk of neurologic deficit in posterior vertebral column resection surgery. Spine. 2016 Sep 15;41(18):1447e1455. http://dx.doi.org/10.1097/BRS.0000000000001547.

14. Akbar M, Terran J, Ames CP, Lafage V, Schwab F. Use of Surgimap Spine in sagittal plane analysis, osteotomy planning, and correction calculation. Neurosurg Clin N Am. 2013 Apr;24(2):163e172. http://dx.doi.org/10.1016/j.nec.2012.12.007.

15. Emans John B. Intraoperative neuromonitoring applications and issues in pediatric spinal deformity surgery. Spine Deform. 2012:71e74. http://dx.doi.org/ 10.1016/j.jspd.2012.05.001 (preview September) Published online: 2012 August 23.

16. McMaster MJ, Singh H. Natural history of congenital kyphosis and kyphoscoliosis. A study of one hundred and twelve patients. J Bone Jt Surg Am. 1999 Oct;81(10):1367e1383.

17. Winter RB, Moe JH, Wang JF. Congenital kyphosis. Its natural history and treatment as observed in a study of one hundred and thirty patients. J Bone Jt Surg Am. 1973 Mar;55(2):223e256.

18. Sar C, Eralp L. Three-stage surgery in the management of severe rigid angular kyphosis. Eur Spine J. 2002 Apr;11(2):107e114. http://dx.doi.org/10.1007/ s00586-001-0356-8.

19. Zhang Z. Late onset Pott's paraplegia in patients with upper thoracic sharp kyphosis. Int Orthop. 2012 Feb;36(2):381e385. http://dx.doi.org/10.1007/ s00264-011-1285-8.

20. Bilsel N, Aydingoz O, Hanci M, Erdogan F. Late onset Pott's paraplegia. Spinal Cord. 2000 Nov;38(11):669e674.

21. Tuli SM. Severe kyphotic deformity in tuberculosis of the spine. Int Orthop. 1995 Oct;19(5):327e331. http://dx.doi.org/10.1007/BF00181121.

22. Moon MS, Moon JL, Moon YW, et al. Pott's paraplegia in patients with severely deformed dorsal or dorsolumbar spines: treatment and prognosis. Spinal Cord. 2003 Mar;41(3):164e171. http://dx.doi.org/10.1038/sj.sc.3101366.

23. Curtis BH, Fisher RL, Butterfield WL, Saunders FP. Neurofibromatosis with paraplegia. Report of eight cases. J Bone Jt Surg Am. 1969 Jul;51(5):843e861.

24. Deguchi M, Kawakami N, Saito H, Arao K, Mimatsu K, Iwata H. Paraparesis after rib penetration of the spinal canal in neurofibromatous scoliosis. J Spinal Disord. 1995 Oct;8(5):363e367.

25. Winter RB, Lonstein JE, Anderson M. Neurofibromatosis hyperkyphosis: a review of 33 patients with kyphosis of 80 degrees or greater. J Spinal Disord. 1988;1(1):39e49.

26. Song KS, Chang BS, Yeom JS, Lee JH, Park KW, Lee CK. Surgical treatment of severe angular kyphosis with myelopathy: anterior and posterior approach with pedicle screw instrumentation. Spine. 2008 May 15;33(11):1229e1235. http://dx.doi.org/10.1097/BRS.0b013e31817152b3.

27. Chang KW, Cheng CW, Chen HC, Chen TC. Correction hinge in the compromised cord for severe and rigid angular kyphosis with neurologic deficits. Spine. 2009 May 1;34(10):1040e1045. http://dx.doi.org/10.1097/BRS.0b013e31819c105f.

28. Herbert JJ. Vertebral osteotomy; technique, indications and results. J Bone Jt Surg Am. 1948 Jul;30A(3):680e689.

29. Demirkiran G, Dede O, Karadeniz E, Olgun D, Ayvaz M, Yazici M. Anterior and posterior vertebral column resection versus posterior-only technique: a comparison of clinical outcomes and complications in congenital kyphoscoliosis. Clin Spine Surg. 2016 Jun 20. http://dx.doi.org/10.1097/BSD.0000000000000348 [Epub ahead of print].

30. Fan Y, Xia Y, Zhao H, et al. Complications analysis of posterior vertebral column resection in 40 patients with spinal tumors. Exp Ther Med. 2014 Nov;8(5): 1539e1544. http://dx.doi.org/10.3892/etm.2014.1929.

31. 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. 2015 Dec 11. http://dx.doi.org/10.1007/s00586-015-4344-9 [Epub ahead of print].

32. Sacramento-Domínguez C, Yagi M, Ayamga J, et al. Apex of deformity for threecolumn osteotomy. Does it matter in the occurrence of complications? FOCOS Spine Research Group. Spine J. 2015 Nov 1;15(11):2351e2359. http:// dx.doi.org/10.1016/j.spinee.2015.07.010.

33. Atici Y, Sokücü S, Uzümcügil O, Albayrak A, Erdo € gan S, Kaygusuz MA. The re- sults of closing wedge osteotomy with posterior instrumented fusion for the surgical treatment of congenital kyphosis. Eur Spine J. 2013 Jun;22(6): 1368e1374. http://dx.doi.org/10.1007/s00586-013-2755-z.

34. Kim SS, Cho BC, Kim JH, et al. Complications of posterior vertebral resection for spinal deformity. Asian Spine J. 2012 Dec;6(4):257e265. http://dx.doi.org/ 10.4184/asj.2012.6.4.257.

35. Chen Y, Chen D, Guo Y, et al. Subsidence of titani-um mesh cage :a study based on 300 cases. J Spinal Disord Tech. 2008 Oct;21(7):489e492. http://dx.doi.org/ 10.1097/BSD.0b013e318158de22.

36. Ogura Y, Watanabe K, Hosogane N, Toyama Y, Matsumoto M. Acute respiratory failure due to hemothorax after posterior correction surgery for adolescent idiopathic scoliosis: a case report. BMC Musculoskelet Disord. 2013 Apr 11;14: 132. http://dx.doi.org/10.1186/1471-2474-14-132.

37. Shapiro G, Green DW, Fatica NS, Boachie-Adjei O. Medical complications in scoliosis surgery. Curr Opin Pediatr. 2001 Feb;13(1):36e41.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
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