Related Experiment Video
Updated: Aug 14, 2025
Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Severe kyphoscoliosis correction utilizing sublaminar bands in the setting of a vertebral column resection: a unique
Luke Mugge1, Danielle Dang2, Kelsey Cobourn3
1Department of Neurosciences, Inova Neuroscience and Spine Institute, 3300 Gallows Road, Falls Church, VA, 22042, USA. lukealan.mugge@inova.org.
Purpose:
Severe kyphoscoliosis produces combined coronal and sagittal imbalance, a challenging presentation of Adult Spinal Deformity (ASD). Vertebral column resection (VCR) provides three-dimensional correction typically reserved for severe and/or fixed deformities. The challenge of a VCR is to stabilize the spinal column during incremental reduction maneuvers to correct the deformity. We describe novel use of sub-laminar bands with a temporary pivoting rod construct to achieve coronal and sagittal correction in one reductive maneuver.
Methods:
All available notes, imaging, and reports were summarized for inclusion.
Results:
A 67-year-old male presented severe, progressive thoracolumbar kyphoscoliosis, subsequent back pain, and difficulty in ambulating. Given the progression, surgical intervention was undertaken. The patient underwent an L3 VCR followed by instrumentation from T2 to pelvis. Kyphoscoliosis correction was performed via a single reduction maneuver using novel pivoting-rod construct and sub-laminar bands followed by quad-rod construct placement. Fresh, frozen, femoral head allograft, and BMP were utilized. The patient was placed in a Jewett brace for 6 weeks postoperatively and recovered. His condition remains optimized at three-year follow-up.
Conclusion:
Correcting three-dimensional deformities can require vertebral column resection and pose risk during correction. We propose a sub-laminar band with a pivot-rod construct as a safe, effective technique, limiting the number of reduction maneuvers.
