title: Posterior vertebral column resection for severe rigid scoliosis.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To report on the technique and results of posterior vertebral column resection (PVCR) for severe rigid scoliosis.
  
  
  BACKGROUND
  The treatment of severe rigid scoliosis is a demanding surgical challenge. Conventional procedures such as combined anteroposterior instrumentation enable limited correction. In rigid scoliosis, vertebral column resection is a better option for accomplishing translation of spinal column. PVCR is performed through a single posterior approach.
  
  
  METHODS
  A total of 16 patients with scoliosis (average age 29 years) subjected to PVCR were retrospectively reviewed after a minimum follow-up of 2 years (range 2-6.8). The indication for PVCR was scoliosis more than 80 degrees , with flexibility less than 25%. The radiographic parameters were evaluated, and clinical records were reviewed.
  
  
  RESULTS
  The number of vertebrae removed averaged 1.3, and 21 total (15 thoracic and 6 lumbar). Average fusion extent was 10.6 vertebrae. The mean preoperative scoliosis of 109.0 degrees was corrected to 45.6 degrees (59% correction) at the most recent follow-up, and the minor curve of 59.3 degrees was corrected to 29.2 degrees (51% correction). The mean preoperative coronal imbalance of 4.0 cm was improved to 1.0 cm at the most recent follow-up, and sagittal imbalance of 4.2 cm was improved to 1.6 cm. Complications were encountered in 4 patients, including 1 complete paralysis, 1 hematoma, 1 hemopneumothorax, and 1 proximal junctional kyphosis.
  
  
  CONCLUSIONS
  PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.
authors: Seoul Spine Institute, Inje University Sanggye-Paik Hospital, Seoul, Korea. seilsuk@unitel.co.kr
authors: Se-Il
authors: SI
authors: Suk
authors: Ewy-Ryong
authors: ER
authors: Chung
authors: Jin-Hyok
authors: JH
authors: Kim
authors: Sung-Soo
authors: SS
authors: Kim
authors: Jung-Sub
authors: JS
authors: Lee
authors: Won-Kee
authors: WK
authors: Choi
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome