title: The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis.
abstract: The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis.
  
  
  
  24 patients with isolated angular congenital kyphosis treated by PVCR in our hospital were retrospectively studied. The patients' radiographs and hospital records were reviewed. Deformity in sagittal planes and global sagittal alignment were analyzed for correction and maintenance of the correction in preoperative, postoperative, and follow-up radiographs. The complications and related risk factors were analyzed.
  
  
  
  The average age was 13.9 (4-40) years. Three of them were revision surgeries. Two patients have intraspinal anomalies. The mean follow-up is 56.9 (26-129) months. The mean operation time was 293.1 (170-480) min. The averaged blood loss was 993.8 (250-3000) ml. The segmental kyphosis was 87.3° before surgery, 17.6° post surgery and 20.4° at the latest the follow-up. And the sagittal vertical axis was improved from 43.1 mm to 9.2 mm. Mean total score of SRS-22 was 89.3. Complications occurred in 4 patients, including 1 screw pullout due to pseudarthrosis, 1 proximal junctional kyphosis, 1 incomplete spinal cord injury and 1 root injuries.
  
  
  
  Posterior-only vertebral column resection is an ideal procedure for severe rigid congenital kyphosis. However, it is still a highly technical demanding procedure. Neurological compromises still remain the biggest challenges. Sufficient height of anterior reconstruction, avoidance sacrifice of bilateral roots in the same level in the thoracic spine, avoidance of the sagittal translation of the upper and lower vertebras, intra-operative neuromonitoring, and preoperative surgical release of diastematomyelia and tethered cord may help to improve the safety.
authors.affiliation: Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
authors.forename: Shengru
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery of Traditional Chinese Hospital Affiliated To Xinjiang Medical University, Urumqi, 830000, China.
authors.forename: Kahaer
authors.initials: K
authors.lastname: Aikenmu
authors.affiliation: Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China. jgzhang_pumch@yahoo.com.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
authors.forename: Guixing
authors.initials: G
authors.lastname: Qiu
authors.affiliation: Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
authors.forename: Yanbin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics of Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
authors.forename: Xisheng
authors.initials: X
authors.lastname: Weng
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complications; Isolated angular congenital kyphosis; Posterior vertebral column resection; Results; Risk factors