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. 2012 Dec;6(4):257-65.
doi: 10.4184/asj.2012.6.4.257. Epub 2012 Dec 14.

Complications of posterior vertebral resection for spinal deformity

Sung-Soo Kim  1 , Beom-Cheol Cho, Jin-Hyok Kim, Dong-Ju Lim, Ji-Yong Park, Beom-Jung Lee, Se-Il Suk
Affiliations

Complications of posterior vertebral resection for spinal deformity

Sung-Soo Kim et al. Asian Spine J. 2012 Dec.

Abstract

Study design: Retrospective study.

Purpose: To evaluate the incidence and risk factors of complications following posterior vertebral resection (PVR) for spinal deformity.

Methods: A review of 233 patients treated with PVR at one institution over a nine-year period (1997 to 2005) was performed. The average age was 33.5 years. Complications were assessed in terms of surgical techniques (posterior vertebral column resection [PVCR] and decancellation osteotomy) and etiologies of deformity.

Results: Local kyphosis was corrected from 51.4° to 2.7°, thoracic scoliosis 63.9° to 24.5° (62.6% correction), and thoracolumbar or lumbar scoliosis 50.1° to 17.1° (67.6%). The overall incidence of complications was 40.3%. There was no significant difference between PVCR and decancellation osteotomy in the incidence of complications. There were more complications in the older patients (>35 years) than the younger (p < 0.05). Hig her than 3,000 ml of blood loss and 200 minutes of operation time increased the incidence of complications, with significant difference (p < 0.05). More than 5 levels of fusion significantly increased the total number of complications and postoperative neurologic deficit (p < 0.05). Most of the postoperative paraplegia cases had preoperative neurologic deficit. Preoperative kyphosis, especially in tuberculous sequela, had hig her incidences of complications and postoperative neurologic deficit (p < 0.05). More than 40° of kyphosis correction had the tendency to increase complications and postoperative neurologic deficit without statistical significance (p > 0.05). There was 1 mortality case by heart failure. Revision surgery was performed in 15 patients for metal failure or progressing curve.

Conclusions: The overall incidence of complications of PVR was 40.3%. Older age, abundant blood loss, preoperative kyphosis, and long fusion were risk factors for complications.

Keywords: Decancellation osteotomy; Posterior vertebral column resection; Posterior vertebral resection; Postoperative complications.

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