title: Posterior Only Vertebral Column Resection for the Treatment of Severe Spinal Deformities in Pediatric Patients: A Retrospective Case Series.
abstract: OBJECTIVE
  The treatment of severe spinal deformities in pediatric patients is very challenging. Posterior only vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column via a posterior only procedure. We analyzed radiologic outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities.
  
  
  METHODS
  A case series of 11 pediatric patients with severe spinal deformity who were treated by PVCR between 2009 and 2013 were retrospectively analyzed. All patients had posterior instrumentation and reconstruction of the anterior column with titanium cages filled with autologous bone. Seven patients had pure kyphosis or kyphoscoliosis, whereas 4 patients were treated because of scoliotic deformities. The patient records were reviewed for demographic and general clinical data. Complications and adverse events, transfusion rates, and surgical time were recorded. Radiologic analysis included Cobb angles and percentage of correction, analysis of sagittal profile, time to fusion, and possible complications related to instrumentation.
  
  
  RESULTS
  Average preoperative scoliosis of 61° was corrected to 32°, resulting in a 50% correction at final follow-up. Coronal imbalance was improved to 36% at the most recent follow-up. Mean preoperative kyphotic deformity was 90° and was corrected to 43° at the last follow-up evaluation. Intraoperative complications included loss of the neuromonitoring signals in 2 cases and pleural laceration in 1 case.
  
  
  CONCLUSIONS
  PVCR for children is an effective and safe technique providing a successful correction of complex pediatric spinal deformities. Nevertheless, it remains a technically highly demanding procedure, implying the possibility of severe complications.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Pediatric Orthopedic Surgery, Altona Children's Hospital, Hamburg, Germany. Electronic address: m.schroeder@uke.de.
authors.forename: Malte
authors.initials: M
authors.lastname: Schroeder
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Trauma, Orthopedic Surgery and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany.
authors.forename: Lennart
authors.initials: L
authors.lastname: Viezens
authors.affiliation: Department of Pediatric Neurosurgery, Altona Children's Hospital, Hamburg, Germany.
authors.forename: Philip
authors.initials: P
authors.lastname: Kunkel
authors.affiliation: Department of Pediatric Orthopedic Surgery, Altona Children's Hospital, Hamburg, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Ridderbusch
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Tim Nicolas
authors.initials: TN
authors.lastname: Hissnauer
authors.affiliation: Department of Pediatric Orthopedic Surgery, Altona Children's Hospital, Hamburg, Germany.
authors.forename: Oliver Dirk
authors.initials: OD
authors.lastname: Jungesblut
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hoffmann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Johannes Maria
authors.initials: JM
authors.lastname: Rueger
authors.affiliation: Department of Pediatric Orthopedic Surgery, Altona Children's Hospital, Hamburg, Germany; Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Stuecker
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods; D016896:Treatment Outcome
keywords: Pediatric spine; Revision surgery; Vertebral column resection