Posterior vertebral column resection for rigid angular kyphosis.

Abstract

Objective To evaluate the effect of single-stage posterior vertebral column resection for rigid angular kyphosis.Methods From May 2001 to December 2007,a consecutive series of 41 patients with rigid angular kyphosis were treated by posterior vertebral column resection.The mean preoperative Cobb angle of kyphosis was 43.8°,and the Cobb angle of scoliosis was 39.1°.The coronal and the sagittal angles were analyzed to determine the corrective effect of kyphosis and scoliosis on standing anterior-posterior and lateral plain films.Trunk balance and Frankel grade were also measured before and after operation.Results The average time of follow-up was 47 months (range,from 16 months to 87 months).Intraoperative,two patients had pedicle fracture,three cases underwent pedicle screw pull out.There was a mean improvement of 77.6% for kyphosis from a mean angle of 43.8° before surgery to 9.8° two weeks after surgery.The correcton ratio for scoliosis was 74.4%,improved from 39.1° to 10.0°.Deformity angle and the trunk balance were significantly improved postoperatively.Postoperative complication included: pneumothorax in 1 patient;local infection in 2 patients and neurological dysfunction in 6 patients.Postoperative neurologic improvement was observed in four patients,No obvious relief was found in 2 patients.Only one patient.whose Frankel grade had changed from C to B had worsen.There were grade E in 3 patients, grade D in 3 patients and grade B in 1 patient. All patients got bony fusion within 6 months.There was no obviously correction loss at the final follow up (P>0.05).Conclusion Single-stage posterior vertebral column resection a reliable and safe surgical technique for correcting rigid angular kyphosis. Key words: Kyphosis ; Spinal fusion ; Treatment outcome ;