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Posterior vertebral column resection can be effective in management of hyperkyphosis
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For the management of thoracolumbar and thoracic hyperkyphosis, posterior vertebral column resection was an effective procedure, producing improvements in overall kyphosis and clinical outcomes, according to findings from a recently published study.
Researchers retrospectively analyzed 45 patients from 2002 to 2009 who underwent posterior vertebral column resection (PVCR) performed through a single posterior approach for the correction of severe rigid kyphosis. Kyphosis was due to congenital deformity in nine patients and was secondary to tuberculosis of the spine in 36 patients.
The researchers recorded patients’ preoperative demographics, preoperative and postoperative neurologic status, SRS-22 scores, and complications and reviewed upright full spine X-rays for all of the patients.
According to the researchers, the average kyphosis was 108°, which was corrected to an average of 60° postoperatively. About 22% of patients experienced intraoperative monitoring changes, and one patient experienced a complete spinal cord injury. Ten patients had to undergo revision surgeries after their procedures for a variety of reasons.
No patient displayed neurological deficiencies post-surgery, and of 11 patients who had postoperative gait disturbances, four improved to normal motor strength and gain. Five showed no gait changes, but three of the five patients were wheelchair bound and two had spastic gait.
Patients experienced statistically significant improvement in the self-image portion of the SRS-22 score, with improvement from 2.24 to 3.77 (P = .002), according to the researchers.
The researchers concluded the procedure is effective, enables direct anterior spinal cord decompression and allows for severe angular kyphotic deformity correction. – by Robert Linnehan
Disclosures: Papadopoulos reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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