title: Complications of posterior vertebral resection for spinal deformity.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To evaluate the incidence and risk factors of complications following posterior vertebral resection (PVR) for spinal deformity.
  
  
  METHODS
  A review of 233 patients treated with PVR at one institution over a nine-year period (1997 to 2005) was performed. The average age was 33.5 years. Complications were assessed in terms of surgical techniques (posterior vertebral column resection [PVCR] and decancellation osteotomy) and etiologies of deformity.
  
  
  RESULTS
  Local kyphosis was corrected from 51.4° to 2.7°, thoracic scoliosis 63.9° to 24.5° (62.6% correction), and thoracolumbar or lumbar scoliosis 50.1° to 17.1° (67.6%). The overall incidence of complications was 40.3%. There was no significant difference between PVCR and decancellation osteotomy in the incidence of complications. There were more complications in the older patients (>35 years) than the younger (p < 0.05). Hig her than 3,000 ml of blood loss and 200 minutes of operation time increased the incidence of complications, with significant difference (p < 0.05). More than 5 levels of fusion significantly increased the total number of complications and postoperative neurologic deficit (p < 0.05). Most of the postoperative paraplegia cases had preoperative neurologic deficit. Preoperative kyphosis, especially in tuberculous sequela, had hig her incidences of complications and postoperative neurologic deficit (p < 0.05). More than 40° of kyphosis correction had the tendency to increase complications and postoperative neurologic deficit without statistical significance (p > 0.05). There was 1 mortality case by heart failure. Revision surgery was performed in 15 patients for metal failure or progressing curve.
  
  
  CONCLUSIONS
  The overall incidence of complications of PVR was 40.3%. Older age, abundant blood loss, preoperative kyphosis, and long fusion were risk factors for complications.
authors.affiliation: Department of Orthopaedics, Seoul Spine Institute, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Beom-Cheol
authors.initials: BC
authors.lastname: Cho
authors.forename: Jin-Hyok
authors.initials: JH
authors.lastname: Kim
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Lim
authors.forename: Ji-Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Beom-Jung
authors.initials: BJ
authors.lastname: Lee
authors.forename: Se-Il
authors.initials: SI
authors.lastname: Suk
keywords: Decancellation osteotomy; Posterior vertebral column resection; Posterior vertebral resection; Postoperative complications