title: Anterior and posterior vertebral column resection for severe and rigid idiopathic scoliosis.
abstract: A total of 16 patients with severe and rigid idiopathic scoliosis treated by anterior and posterior vertebral column resection (APVCR) were retrospectively reviewed after a minimum follow-up of 2 years. The indication for APVCR was scoliosis more than 90° with flexibility less than 20%. The radiographic parameters were evaluated, and clinical records were reviewed. All patients underwent APVCR with posterior pedicle screw instrumentation in a two-stage surgery. The rib hump was reduced from 7.2 cm preoperatively to 1.8 cm at final follow-up (75% correction). Preoperative curves ranged from 93° to 110° Cobb angle. Coronal plane correction of the major curve averaged 67% with an average loss of correction of 1.4%. The apical vertebral translation of the major curve was corrected by 63.5%. The preoperative coronal imbalance of 0.9 cm (range 0-2.4) was improved to 0.8 cm (range 0.1-1.7) at the most recent follow-up. The preoperative sagittal imbalance of 1.0 cm (range -3.1 to 4.6) was improved to 0.9 cm (range -2.6 to 3.0) at the most recent follow-up. Complications were encountered in four patients. One patient required ventilator support for 12 h after anterior surgery. Malposition of one pedicle screw was found in one patient. Malposition of titanium mesh cage happened to two patients. There were no neurological complications, deep wound infections or pseudarthrosis. APVCR is an effective alternative for severe and rigid idiopathic scoliosis.
authors.affiliation: Department of Orthopedics, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, People's Republic of China.
authors.forename: Chunguang
authors.initials: C
authors.lastname: Zhou
authors.forename: Limin
authors.initials: L
authors.lastname: Liu
authors.forename: Yueming
authors.initials: Y
authors.lastname: Song
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.forename: Quan
authors.initials: Q
authors.lastname: Gong
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Zeng
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Kong
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws / Q000592:standards; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis; D019736:Prostheses and Implants / Q000592:standards; 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; D055815:Young Adult