Posterior Vertebral Column Resection for Severe and Rigid Spinal Deformity Associated With Neurological Deficit After Implant Removal Following Posterior Instrumented Fusion

Tao, Youping; Wu, Jigong; Ma, Hui; Zhang, Lele; Shao, Shihe; Si, Zebing; Gao, Bo; Ji, Yong; Li, Haixia; Tao, Feifei

doi:10.1097/brs.0000000000000921

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…When all instrumentation is removed for infection, pain, or hardware failure, patients with scoliosis treated with PSF can experience curve progression with an average increase in thoracic deformity of 10°to 23°despite the presence of a solid fusion mass at the time of implant removal [5][6][7]10,11,13 . In some instances, severe curve progression after implant removal has required revision PSF with instrumentation to correct the deformity [14][15][16] . Although the presence of infection may predispose patients to the development of a subclinical pseudarthrosis, Alpert et al found that for patients without infection, deformity still increased an average of 19°after implant removal, compared with an average of 34°in the infected cohort 6 .…”

Section: Discussionmentioning

confidence: 99%

Partial Removal of Spinal Implants for Pain After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Tetreault,

Gasca,

Chen

et al. 2024

JBJS Journal of Orthopaedics for Physician Assistants

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Cases: This case report describes 3 patients who developed focal pain and tenderness over prominent spinal implants after posterior spinal fusion for adolescent idiopathic scoliosis. All patients elected to proceed with removal of only the symptomatic implants, with good relief of preoperative symptoms. At the latest follow-up, there was no significant change in spinal alignment and all patients had returned to activity. Conclusion: Partial removal of symptomatic implants is a viable option after spinal fusion surgery and can effectively relieve focal pain secondary to implant prominence without progression of spinal deformity.

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Section: Discussionmentioning

confidence: 99%

Partial Removal of Spinal Implants for Pain After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Tetreault,

Gasca,

Chen

et al. 2024

JBJS Journal of Orthopaedics for Physician Assistants

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“…Suk et al 17) have introduced posterior VCR (PVCR) procedure. Thereafter several researchers reported the outcomes following PVCR sequentially 12 , 17 , 18 , 20) . The PVCR has purposed at the decrease of complications and technical difficulties of the traditional anterior-posterior VCR 17) .…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities

Lee

Hyun

Kim

et al. 2018

J Korean Neurosurg Soc

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ObjectiveThe aim of this study was to investigate clinical and radiological outcomes of patients who underwent posterior vertebral column resection (PVCR) by a single neurosurgeon in a single institution.MethodsThirty-four consecutive patients with severe spinal deformities who underwent PVCR between 2010 and 2016 were enrolled. The radiographic measurements included a kyphotic angle of PVCR levels (VCR angle), sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis (LL), and spinopelvic parameters. The data of surgical time, estimated blood loss, duration of hospital stay, complications, intraoperative neurophysiologic monitoring, and the Scoliosis Research Society (SRS)-22 questionnaire were collected using a retrospective review of medical records.ResultsThe VCR angle, LL, and SVA values were significantly corrected after surgery. The VCR and LL angle were changed from the average of 38.4±32.1° and −22.1±39.1° to −1.7±29.4° (p<0.001) and −46.3±23.8° (p=0.001), respectively. The SVA was significantly reduced from 103.6±88.5 mm to 22.0±46.3 mm (p=0.001). The clinical results using SRS-22 survey improved from 2.6±0.9 to 3.4±0.8 (p=0.033). There were no death and permanent neurological deficits after PVCR. However, complications occurred in 19 (55.9%) patients. Those patients experienced a total of 31 complications during- and after surgery. Sixteen reoperations were performed in twelve (35.3%) patients. The incidence of transient neurological deterioration was 5.9% (two out of 34 patients).ConclusionSevere spinal deformities can be effectively corrected by PVCR. However, the PVCR technique should be utilized limitedly because surgery-related serious complications are relatively common.

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Fractures After Removal of Spinal Instrumentation: Revisiting the Stress-Shielding Effect of Instrumentation in Spine Fusion

et al. 2018

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Posterior Vertebral Column Resection for Severe and Rigid Spinal Deformity Associated With Neurological Deficit After Implant Removal Following Posterior Instrumented Fusion

Abstract: N/A.

Cited by 5 publications

References 18 publications

Partial Removal of Spinal Implants for Pain After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Partial Removal of Spinal Implants for Pain After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities

Fractures After Removal of Spinal Instrumentation: Revisiting the Stress-Shielding Effect of Instrumentation in Spine Fusion

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