Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus

Area of Science:

• Spine surgery
• Orthopedic surgery
• Deformity correction

Background:

• Posterior vertebral column resection (PVCR) is gaining traction for severe, rigid spinal deformities.
• High-level evidence guiding PVCR remains limited, necessitating expert consensus.
• This study aimed to consolidate strategies and technical nuances from experienced Chinese surgeons.

Framework:

• A modified Delphi process involving nationwide experts and multiple consultations.
• Formation of eight task forces to address key issues in PVCR.
• Consensus building through literature review, expert opinion collection, and face-to-face meetings.

Implementation:

• Consensus reached on critical aspects: indications/contraindications, corrective mechanisms, spinal cord safety, and complication management.
• Focus on monitoring spinal cord crises and managing intraoperative bleeding.
• Analysis of pulmonary function outcomes and non-neurologic complications.

Implications:

• PVCR is primarily indicated for severe, rigid spinal deformities unresponsive to other techniques.
• Optimal PVCR outcomes depend on precise surgical indications, resection levels, correction strategies, and neurological risk control.
• Standardized expert consensus provides a foundation for refining PVCR procedures and enhancing patient safety.