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

Abstract

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.