Posterior vertebral column resection for pediatric rigid spinal deformity

Ould-Slimane, Mourad; Nabian, Mohammad Hossein; Simon, Anne-Laure; Happiette, Adèle; Julien-Marsollier, Florence; Ilharreborde, Brice

doi:10.1016/j.otsr.2020.102797

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…The fourth case needed unilateral sectioning of the L2 root to complete PVCR procedure. 5 In our series, temporary neuromonitoring changes happened in 2 patients (8%) and excessive EBL (>1500 mL) occurred in 1 patient. No nerve root was cut during the procedure, and no postoperative pulmonary obstacles, infections, or death have been observed.…”

Section: Discussionmentioning

confidence: 51%

“… 4 In pediatric patients with lumbar or thoracolumbar curves, in particular, tiny motor nerve roots may compromise the technique and increase the likelihood of the undercorrection of the deformity or cause further complications. 5 …”

Section: Discussionmentioning

confidence: 99%

“…The second most common complication was an EBL of >2 L. The most common early postoperative complications were pulmonary related. 6 Ould-Slimane et al 5 reported 13 PVCR pediatric patients, with significant evoked potential changes in 4 patients (25%). Two had complete recovery without construct modification, and 1 experienced unilateral evoked potential drop, which was followed by spontaneous recovery after 6 weeks.…”

Section: Discussionmentioning

confidence: 99%

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Thoracolumbar and Lumbar Posterior Vertebral Resection for the Treatment of Rigid Congenital Spinal Deformities in Pediatric Patients: A Long-Term Follow-up Study

Karami

Zandi

Hassani

et al. 2022

World Neurosurgery: X

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Thoracolumbar and Lumbar Posterior Vertebral Resection for the Treatment of Rigid Congenital Spinal Deformities in Pediatric Patients: A Long-Term Follow-up Study

Karami

Zandi

Hassani

et al. 2022

World Neurosurgery: X

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“…VCR involves complete vertebrectomy, can be performed by a posterior costo-transversectomy approach, and requires the stabilisation of the vertebral column during and after resection along with anterior column reconstruction [ 129 ]. PSO is particularly effective for correcting kyphoscoliosis or lumbar lordosis, and VCR is particularly effective for severe focal spinal deformity requiring shortening or rotational correction [ 130 ].…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Paediatric Spinal Deformity Surgery: Complications and Their Management

Roberts

2022

Healthcare

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Surgical correction of paediatric spinal deformity is associated with risks, adverse events, and complications that must be preoperatively discussed with patients and their families to inform treatment decisions, expectations, and long-term outcomes. The incidence of complications varies in relation to the underlying aetiology of spinal deformity and surgical procedure. Intraoperative complications include bleeding, neurological injury, and those related to positioning. Postoperative complications include persistent pain, surgical site infection, venous thromboembolism, pulmonary complications, superior mesenteric artery syndrome, and also pseudarthrosis and implant failure, proximal junctional kyphosis, crankshaft phenomenon, and adding-on deformity, which may necessitate revision surgery. Interventions included in enhanced recovery after surgery protocols may reduce the incidence of complications. Complications must be diagnosed, investigated and managed expeditiously to prevent further deterioration and to ensure optimal outcomes. This review summarises the complications associated with paediatric spinal deformity surgery and their management.

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“…T hree-column osteotomies (3CO), mainly including pedicle subtraction osteotomy (PSO), 1 SRS-Schwab grade 4 osteotomy 2 and vertebral column resection (VCR), 3 have been widely used in the treatment of severe kyphoscoliosis. 4,5 Whereas, the post-operative complications, such as rod fracture, are increasingly observed in clinical practice. 6,7 Suk et al 8 reported that the incidence of internal fixation failure was approximately 7.1% in patients undergoing posterior VCR.…”

Section: Introductionmentioning

confidence: 99%

Satellite Rod Fixation around Rod‐fracture Area in Revision Surgery after Three‐column Osteotomy for Severe Kyphoscoliosis

Liu

Shi

Liu

et al. 2023

Orthopaedic Surgery

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Objective: Three-column osteotomy (3CO) is considered valuable and increasingly utilized in the surgical treatment of severe spine deformity while associated with high implant-related complications and revision risks. This study aims to evaluate the feasibility and clinical outcomes of satellite rod fixation used around the rod-fracture area in revision surgery due to rod fracture after 3CO.Methods: Twenty-five patients applying satellite rod fixation in revision surgery from August 2012 to May 2016 were retrospectively reviewed as the SR group. Patients undergoing revision surgery with traditional strategy after 3CO due to rod-fracture were selected as the TR group. Cobb angle, distance between C 7 plumb line and center sacral vertical line (C 7 PL-CSVL), global kyphosis (GK) and sagittal vertical axis (SVA) were assessed. Patients were required to fulfill the Scoliosis Research Society-22 questionnaire (SRS-22) at pre-revision and the last follow-up. The paired t test was used to analyze the difference among pre-revision, post-revision and last follow-up.Results: There was no statistical difference in terms of age, gender, body mass index (BMI), fusion level at 1st surgery, and follow-up period between SR and TR group (all P > 0.05). The operation time (1.5 AE 0.7 h vs 3.2 AE 0.9 h, P < 0.001) and intraoperative blood loss (178 AE 51 mL vs 324 AE 96 mL, P < 0.001) were significantly higher in the TR group. Patients in both groups obtained obvious deformity correction after revision surgery. For patients in SR group, the coronal Cobb angle significantly improved from 27.9 AE 21.5 at pre-revision to 21.8 AE 16.6 at postrevision (P = 0.034). The C 7 PL-CSVL decreased from 22.6 AE 14.3 mm to 21.3 AE 10.9 mm (P = 0.719). Similarly, improvement was attained in post-revision GK (25.8 AE 17.0 vs 20.2 AE 15.1 , P = 0.061). SVA was corrected from 35.6 AE 33.9 mm to 30.8 AE 24.3 mm after revision (P = 0.182). At the last follow-up, no significant correction loss was observed in both coronal and sagittal parameters (all P > 0.05). All patients responded to the SRS-22 questionnaire and all the domains showed improvements in different levels. As compared to the TR group, the SR group had significantly better pain and management satisfaction scores (all P < 0.05). Additionally, there was no reoccurrence of implant failure during follow-up and all patients achieved solid bony fusion in SR group. Conclusion:Satellite rod fixation around rod-fracture area is indicated for patients in the requirement of revision surgeries due to rod fracture after 3CO. Compared with traditional revision strategies, revision surgery with satellite rods, if patients are selected adequately, is a simpler procedure with less intraoperative blood loss and shorter operating time.

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Posterior vertebral column resection for pediatric rigid spinal deformity

Cited by 6 publications

References 14 publications

Thoracolumbar and Lumbar Posterior Vertebral Resection for the Treatment of Rigid Congenital Spinal Deformities in Pediatric Patients: A Long-Term Follow-up Study

Thoracolumbar and Lumbar Posterior Vertebral Resection for the Treatment of Rigid Congenital Spinal Deformities in Pediatric Patients: A Long-Term Follow-up Study

Paediatric Spinal Deformity Surgery: Complications and Their Management

Satellite Rod Fixation around Rod‐fracture Area in Revision Surgery after Three‐column Osteotomy for Severe Kyphoscoliosis

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