Posterior vertebral column resection in spinal deformity: a systematic review

Area of Science:

• Spine Surgery
• Orthopedic Surgery
• Deformity Correction

Background:

• Severe spinal deformities necessitate complex surgical interventions.
• Posterior vertebral column resection (PVCR) is an established technique for addressing these conditions.

Purpose of the Study:

• To evaluate the efficacy of PVCR in correcting spinal deformities.
• To assess the complication rates associated with PVCR surgery.

Main Methods:

• Systematic review of MEDLINE, EMBASE, and Cochrane Database for PVCR studies.
• Pooled analysis of data from 7 studies involving 390 patients.
• Correction measured by changes in coronal and sagittal Cobb angles; complications quantified by prevalence.

Main Results:

• PVCR achieved significant correction: 64.1° for scoliosis and 58.9° for kyphosis (61.2% and 63.1% correction rates).
• Overall complication rate was 32%, with neurologic complications at 8% and spinal cord injury at 2%.
• Revision, infection, and implant-related complication rates were 6%, 2%, and 2%, respectively.

Conclusions:

• PVCR is a potent surgical option for severe spinal deformities, offering substantial correction.
• The procedure is associated with considerable risks, including significant blood loss and major complications.
• Careful patient selection and performance by experienced surgical teams are crucial for optimal outcomes.