title: Congenital scoliosis treated with posterior vertebral column resection in patients younger than 18 years: longer than 10-year follow-up.
abstract: OBJECTIVE There have been no reports on the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. The purpose of this study was to evaluate the surgical outcomes and complications after PVCR and its long-term effects on correcting this deformity in children with congenital scoliosis. METHODS The authors retrospectively analyzed the medical records of 45 patients with congenital scoliosis who were younger than 18 years at the time of surgery and who underwent PVCR and fusion with pedicle screw fixation (PSF). The mean age of the patients at the time of surgery was 11.3 years (range 2.4-18.0 years), and the mean length of follow-up was 12.8 years (range 10.1-18.2 years). RESULTS The mean Cobb angle of the main curve was 46.5° before PVCR, 13.7° immediately after PVCR, and 17.6° at the last follow-up. For the compensatory cranial curve, PVCR corrected the preoperative Cobb angle of 21.2° to 9.1° postoperatively and maintained it at 10.9° at the last follow-up. For the compensatory caudal curve, the preoperative Cobb angle of 23.8° improved to 7.7° postoperatively and was 9.8° at the last follow-up. The authors noted 22 complications, and the overall incidence of complications was 48.9%. CONCLUSIONS Posterior vertebral column resection is an effective procedure for managing congenital scoliosis in patients younger than 18 years. Use of PVCR and fusion with PSF for congenital scoliosis achieved rigid fixation and satisfactory deformity correction that was maintained over the long term. However, the authors note that PVCR is a technically demanding procedure and entails risks for major complications and excessive blood loss.
authors.affiliation: Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University;
authors.forename: Dong-Gune
authors.initials: DG
authors.lastname: Chang
authors.affiliation: Department of Orthopaedic Surgery, Guro-Hospital, Korea University;
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Kyung Hee Hospital, Kyung Hee University; and.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University;
authors.forename: Jin-Hyok
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Guro-Hospital, Korea University;
authors.forename: Seung-Woo
authors.initials: SW
authors.lastname: Suh
authors.affiliation: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
authors.forename: Kee-Yong
authors.initials: KY
authors.lastname: Ha
authors.affiliation: Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University;
authors.forename: Se-Il
authors.initials: SI
authors.lastname: Suk
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D065289:Pedicle Screws; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
keywords: CB = coronal balance; LL = lumbar lordosis; MEP = motor evoked potential; PSF = pedicle screw fixation; PVCR = posterior vertebral column resection; SB = sagittal balance; SK = segmental kyphosis; SSEP = somatosensory evoked potential; TK = thoracic kyphosis; congenital scoliosis; hemivertebra; hemivertebra resection; long-term follow-up; pedicle screw fixation; posterior vertebral column resection; spinal disorders