Radiologic Outcomes and Complication Analysis of the Posterior Vertebral Column Resection in the Treatment of Previously Operated Severe Kyphoscoliosis: A Retrospective Case Series.

Autor: Atıcı Y; Department of Orthopedic Surgery, Medical Park Gebze Hospital, Gebze, Kocaeli, Turkey., Polat B; Department of Orthopaedic Surgery, Faculty of Medicine, University of Kyrenia, Kyrenia, Turkish Republic of North Cyprus. Electronic address: drbpolat@hotmail.com., Erdoğan S; Department of Orthopedic Surgery, Baltalimanı Bone and Joint Diseases Training and Research Hospital, Istanbul, Turkey., Çarkçı E; Department of Orthopedic Surgery, Istanbul Training and Resarch Hospital, Istanbul, Turkey., Polat AE; Department of Orthopaedic Surgery, Dr. Akçiçek State Hospital, Kyrenia, Turkish Republic of North Cyprus., Demiröz S; Department of Orthopedic Surgery, Medical Park Gebze Hospital, Gebze, Kocaeli, Turkey., Benli İT; Department of Orthopedic Surgery, Faculty of Medicine, Başkent University, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2020 Jun; Vol. 138, pp. e690-e697. Date of Electronic Publication: 2020 Mar 17.
DOI: 10.1016/j.wneu.2020.03.044
Abstrakt: Objective: The aim of this study was to evaluate the radiologic outcomes and complication analysis of posterior vertebral column resection (PVCR) performed on previously operated patients with severe kyphoscoliosis (SK).
Methods: Twelve patients (6 men and 6 women) with SK underwent PVCR. The mean age of the patients preoperatively was 16 years (range, 10-26 years). The mean follow-up period was 5.3 years (range, 2-7 years). Previous surgeries included posterior growth arrest in 3 patients, hemivertebrectomy in 4 patients, and posterior fusion in 5 patients. The sagittal plane parameters and coronal parameters were measured in the preoperative, in the early postoperative, and during the last follow-up stages. Complications were also noted.
Results: The mean thoracic scoliosis Cobb angle was 76.8° (range, 35°-142°) preoperatively, 37.8° (range, 5°-80°) early postoperatively, and 41.5° (range, 11°-80°) during the last follow-up (P < 0.0001). The mean thoracic kyphosis angle was 84.7° (range, 23°-132°) preoperatively, 50.3° (range, 25°-78°) early postoperatively, and 48.5° (range, 25°-80°) during the last follow-up (P = 0.0032). Complications occurred in 5 patients (41.7%); a hemothorax in 1 patient, rod fracture in 3 patients, and permanent neurologic deficit in 1 patient. Temporary loss of neuromonitoring motor evoked potentials developed in 2 patients during deformity correction.
Conclusions: PVCR provides effective correction in patients with SK. However, expected surgical correction of a deformity may not always be achieved because of intraoperative neuromonitoring changes. Furthermore, PVCR can lead to a large number of major complications in patients with SK who have undergone previous spinal surgery.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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