The safety and efficiency of PVCR without anterior support applied in treatment of Yang's A type severe thoracic kyphoscoliosis.

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The safety and efficiency of PVCR without anterior support applied in treatment of Yang's A type severe thoracic kyphoscoliosis.

World Neurosurg. 2017 May 19;:

Authors: Sui WY, Huang ZF, Deng YL, Fan HW, Yang JF, Li FB, Yang JL

Abstract
OBJECT: To assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang's A type severe rigid thoracic kyphoscoliosis.
METHODS: The records of 27 Yang's A type severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were retrospectively analyzed. Intraoperative multimodal neurophysiological monitoring (IONM) (6 modes: Somatosensory evoked potential (SSEP), Motor evoked potential (MEP), Descending neurogenic evoked potential (DNEP), Spinal cord evoked potential (SCEP), and Electromyography, both triggered and free run EMG) was conducted in all patients. Radiographic parameters and complications were used to evaluate the clinical outcomes.
RESULTS: PVCR without anterior support was successfully conducted in all 27 patients. Intra-operative monitoring events occurred in 3 patients (3/27), of these one (1/27) patient showed postoperative spinal cord injury, but completely recovered within 9 months post-operation (Frankel level E). The number and osteotomy space of vertebrae resection were mean 1.33 levels and 3.7 cm respectively. All cases achieved good coronal and sagittal curve correction. No implant related complications occurred till latest follow-up. The average follow-up was 40.1 months (range 24-59 months).
CONCLUSIONS: In this study we found, posterior vertebral column resection (PVCR) without any anterior support with a mean 3.7 cm shortening of spinal column is safe provided close and unyielding contact of end plates can be obtained. Comprehensive understanding of the technique and intensive intra-operative neuro-monitoring is mandatory to safely perform these challenging and complex spine deformity correction procedures.

PMID: 28532908 [PubMed - as supplied by publisher]

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