title: Posterior 2-Level Vertebral Column Resection for the Treatment of Progressive Rotational Dislocation in Kyphoscoliotic Deformities.
abstract: OBJECTIVE
  Progressive rotational dislocation of the spine is rare and surgical treatment is challenging. Few reports have described surgical decompression, fusion, and partial correction by traditional 2-stage anterior decompression and the posterior fixation technique. The goal of this retrospective study was to report a series of 6 patients with this deformity and the outcome after treatment by posterior-only 2-level vertebral column resection (PVCR).
  
  
  METHODS
  Between 2011 and 2014, 6 patients were treated for kyphoscoliotic deformities with progressive rotational dislocation. In these 6 patients (2 males and 4 females), the diagnosis included 4 cases of congenital kyphosis and 2 cases of neurofibromatosis; the distribution of spine level was from T4 to T11; the kyphosis angle of the patients was 115° (range, 107-125°); the scoliosis angle was 97° (range, 80°-117°); follow-up ranged from 13 to 51 months (mean, 27 months). Four patients developed progressive onset of neurologic deficit. All patients underwent surgery by 2-level PVCR for decompression and correction of kyphoscoliosis.
  
  
  RESULTS
  Postoperatively, the patients all had different kyphosis correction rates, from 49% to 72% (mean, 63%) and scoliosis correction rates, from 57% to 78% (mean, 65%). All patients achieved successful spinal fusion with less than 3° of loss of correction at the latest follow-up evaluation. The 4 patients with incomplete neurologic deficits improved 1 or 2 American Spinal Injury Association scales at follow-up of at least 6 months.
  
  
  CONCLUSIONS
  Two-level PVCR is a safe and efficacious surgical option for the treatment of rotational dislocation in kyphoscoliosis and associated neurologic deficit.
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Shapingba District, Chongqing, China. Electronic address: zhangz3@126.com.
authors.forename: Zhengfeng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Shapingba District, Chongqing, China.
authors.forename: Honggang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Shapingba District, Chongqing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Shangguan
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D008297:Male; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000002:abnormalities / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Kyphoscoliosis; Posterior vertebral column resection; Rotational dislocation