Posterior Only Vertebral Column Resection for the Treatment of Severe Spinal Deformities in Pediatric Patients: A Retrospective Case Series
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Posterior Only Vertebral Column Resection for the Treatment of Severe Spinal Deformities in Pediatric Patients: A Retrospective Case Series. / Schroeder, Malte; Viezens, Lennart; Kunkel, Philip; Ridderbusch, Karsten; Hissnauer, Tim Nicolas; Jungesblut, Oliver Dirk; Hoffmann, Michael; Rueger, Johannes Maria; Stuecker, Ralf.
In: WORLD NEUROSURG, Vol. 101, 05.2017, p. 425-430.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Posterior Only Vertebral Column Resection for the Treatment of Severe Spinal Deformities in Pediatric Patients: A Retrospective Case Series
AU - Schroeder, Malte
AU - Viezens, Lennart
AU - Kunkel, Philip
AU - Ridderbusch, Karsten
AU - Hissnauer, Tim Nicolas
AU - Jungesblut, Oliver Dirk
AU - Hoffmann, Michael
AU - Rueger, Johannes Maria
AU - Stuecker, Ralf
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/5
Y1 - 2017/5
N2 - OBJECTIVE: The treatment of severe spinal deformities in pediatric patients is very challenging. Posterior only vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column via a posterior only procedure. We analyzed radiologic outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities.METHODS: A case series of 11 pediatric patients with severe spinal deformity who were treated by PVCR between 2009 and 2013 were retrospectively analyzed. All patients had posterior instrumentation and reconstruction of the anterior column with titanium cages filled with autologous bone. Seven patients had pure kyphosis or kyphoscoliosis, whereas 4 patients were treated because of scoliotic deformities. The patient records were reviewed for demographic and general clinical data. Complications and adverse events, transfusion rates, and surgical time were recorded. Radiologic analysis included Cobb angles and percentage of correction, analysis of sagittal profile, time to fusion, and possible complications related to instrumentation.RESULTS: Average preoperative scoliosis of 61° was corrected to 32°, resulting in a 50% correction at final follow-up. Coronal imbalance was improved to 36% at the most recent follow-up. Mean preoperative kyphotic deformity was 90° and was corrected to 43° at the last follow-up evaluation. Intraoperative complications included loss of the neuromonitoring signals in 2 cases and pleural laceration in 1 case.CONCLUSIONS: PVCR for children is an effective and safe technique providing a successful correction of complex pediatric spinal deformities. Nevertheless, it remains a technically highly demanding procedure, implying the possibility of severe complications.
AB - OBJECTIVE: The treatment of severe spinal deformities in pediatric patients is very challenging. Posterior only vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column via a posterior only procedure. We analyzed radiologic outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities.METHODS: A case series of 11 pediatric patients with severe spinal deformity who were treated by PVCR between 2009 and 2013 were retrospectively analyzed. All patients had posterior instrumentation and reconstruction of the anterior column with titanium cages filled with autologous bone. Seven patients had pure kyphosis or kyphoscoliosis, whereas 4 patients were treated because of scoliotic deformities. The patient records were reviewed for demographic and general clinical data. Complications and adverse events, transfusion rates, and surgical time were recorded. Radiologic analysis included Cobb angles and percentage of correction, analysis of sagittal profile, time to fusion, and possible complications related to instrumentation.RESULTS: Average preoperative scoliosis of 61° was corrected to 32°, resulting in a 50% correction at final follow-up. Coronal imbalance was improved to 36% at the most recent follow-up. Mean preoperative kyphotic deformity was 90° and was corrected to 43° at the last follow-up evaluation. Intraoperative complications included loss of the neuromonitoring signals in 2 cases and pleural laceration in 1 case.CONCLUSIONS: PVCR for children is an effective and safe technique providing a successful correction of complex pediatric spinal deformities. Nevertheless, it remains a technically highly demanding procedure, implying the possibility of severe complications.
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Kyphosis
KW - Male
KW - Neurosurgical Procedures
KW - Retrospective Studies
KW - Scoliosis
KW - Severity of Illness Index
KW - Spinal Fusion
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1016/j.wneu.2017.01.118
DO - 10.1016/j.wneu.2017.01.118
M3 - SCORING: Journal article
C2 - 28192267
VL - 101
SP - 425
EP - 430
JO - WORLD NEUROSURG
JF - WORLD NEUROSURG
SN - 1878-8750
ER -