title: Vertebral decancellation for severe scoliosis.
abstract: METHODS
  The results of staged surgery including vertebral decancellation were reviewed retrospectively for 21 patients with severe scoliosis.
  
  
  OBJECTIVE
  To evaluate the benefits and limitations of vertebral decancellation as new anterior surgical procedure.
  
  
  BACKGROUND
  The curvatures of severe scoliosis are often very rigid, and surgical correction using the anterior or posterior approach may not achieve the desired correction. Some studies reported neurologic complications might appear due to the aggressive approach or excessive correction force.
  
  
  METHODS
  Twenty-one patients (average age, 17.0 years) with severe scoliosis, in whom Cobb angle was over 80 degrees (average angle, 107 degrees), underwent staged anterior and posterior spinal reconstruction. Vertebral decancellation was performed as anterior procedure, and until posterior instrumentation, halo traction was carried out. The transition of curvatures in coronal and sagittal planes was assessed in this series.
  
  
  RESULTS
  The average correction rate of lateral curvature at the final follow-up was 46%. The average loss of correction was 2.5 degrees. Kyphosis, measured between T5 and T12, changed from 41 degrees to 36 degrees. Lordosis, measured between L1 and S1, changed from 56 degrees to 45 degrees. Transient neurologic deficit was seen in one case after vertebral decancellation.
  
  
  CONCLUSIONS
  Staged surgery including vertebral decancellation is an effective surgical method for patients with severe scoliosis, where an inflexible rigid curve or the risk of occurrence of neurologic complications due to temporary correction may exist.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Chiba University. m-toku@jb3.so-net.ne.jp
authors.forename: M
authors.initials: M
authors.lastname: Tokunaga
authors.forename: S
authors.initials: S
authors.lastname: Minami
authors.forename: H
authors.initials: H
authors.lastname: Kitahara
authors.forename: K
authors.initials: K
authors.lastname: Isobe
authors.forename: Y
authors.initials: Y
authors.lastname: Nakata
authors.forename: H
authors.initials: H
authors.lastname: Moriya
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009984:Orthopedic Fixation Devices; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome