title: Posterior Vertebral Column Resection for Severe and Rigid Spinal Deformity Associated With Neurological Deficit After Implant Removal Following Posterior Instrumented Fusion: A Case Report and Literature Review.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To investigate the safety and efficacy of posterior vertebral column resection for severe and rigid spinal deformity associated with neurological deficit after implant removal following posterior instrumented fusion.
  
  
  BACKGROUND
  Loss of correction after implant removal in patients with posterior instrumented fusion has been previously reported. However, to our knowledge, posterior vertebral column resection (PVCR) for severe and rigid spinal deformity associated with neurological deficit after implant removal following posterior instrumented fusion has not been reported.
  
  
  METHODS
  An 18-year-old female with severe and rigid spinal deformity associated with neurological deficit was classified as Frankel C, according to the Frankel grading system. She underwent posterior spinal fusion with pedicle screw fixation at 16 years, and her implants were removed after 1 year due to back pain. Seven months after removal of the implants, she began to experience weakness in her lower limbs but did not seek any treatment. She was unable to stand and had to use a wheelchair. The patient successfully underwent PVCR and posterior reinstrumentation. Within 3 months, her neurological status improved to Frankel E.
  
  
  RESULTS
  The patient had no neurological deterioration and infections. There was no instrumentation failure and loosening correction at the 32 months follow-up.
  
  
  CONCLUSIONS
  Our results suggest that PVCR and pedicle screw fixation is a safe and efficacious option for severe and rigid spinal deformity associated with neurological deficit after implant removal following posterior instrumented fusion.
  
  
  METHODS
  N/A.
authors.affiliation: From the Department of Orthopaedics, Spinal Center of PLA, the 306th Hospital of PLA, Beijing, China.
authors.forename: Youping
authors.initials: Y
authors.lastname: Tao
authors.forename: Jigong
authors.initials: J
authors.lastname: Wu
authors.forename: Huasong
authors.initials: H
authors.lastname: Ma
authors.forename: Lele
authors.initials: L
authors.lastname: Zhang
authors.forename: Shuilin
authors.initials: S
authors.lastname: Shao
authors.forename: Zebing
authors.initials: Z
authors.lastname: Si
authors.forename: Bo
authors.initials: B
authors.lastname: Gao
authors.forename: Yong
authors.initials: Y
authors.lastname: Ji
authors.forename: Haixia
authors.initials: H
authors.lastname: Li
authors.forename: Feifei
authors.initials: F
authors.lastname: Tao
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001863:Bone Screws; D020878:Device Removal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012086:Reoperation; D012600:Scoliosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome