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Posterior vertebral column resection in fixed lumbosacral deformity
Se-Il Suk1, Ewy-Ryong Chung, Sang-Min Lee
1Seoul Spine Institute, Inje University Sanggye-Paik Hospital, Seoul, Korea. seilsuk@unitel.co.kr
Spine
|December 2, 2005
Summary
Posterior vertebral column resection (PVCR) effectively corrects fixed lumbosacral deformity, improving trunk balance and neurological symptoms. While demanding, this surgical technique offers significant functional outcomes for patients with severe spinal imbalance.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Deformity correction
Background:
- Fixed lumbosacral deformity presents significant imbalance and compensatory thoracolumbar issues due to caudal spinal immobility.
- Surgical management lacks consensus, but Posterior Vertebral Column Resection (PVCR) shows promise in correcting deformity and restoring trunk balance.
Purpose of the Study:
- To evaluate the efficacy and technique of Posterior Vertebral Column Resection (PVCR) for treating fixed lumbosacral deformities.
- To report surgical outcomes, including deformity correction and functional improvements, in patients undergoing PVCR.
Main Methods:
- A retrospective review of 25 patients with fixed lumbosacral deformity treated with PVCR.
- Surgical technique involved posterior segmental pedicle screw fixation, neural decompression, vertebral resection, and fusion.
- Patients were assessed for deformity correction, neurological status, pain, and complications at a minimum 2-year follow-up.
Main Results:
- PVCR achieved significant correction of scoliosis (60%) and kyphosis (40 degrees).
- Coronal and sagittal imbalances were substantially improved, with neurological compromise resolving in all patients and pain significantly reduced.
- Average fusion involved 4.5 vertebrae, with 2.1 vertebrae resected on average. Complications occurred in 5 patients.
Conclusions:
- Posterior Vertebral Column Resection (PVCR) is an effective surgical option for managing fixed lumbosacral deformities.
- The procedure yields satisfactory deformity correction and functional improvements.
- PVCR is technically demanding and carries potential risks, necessitating careful patient selection and surgical expertise.