Posterior Double Vertebral Column Resections Combined with Satellite Rod Technique to Correct Severe Congenital Angular Kyphosis

Abstract

This paper presents a highly challenging technique involving posterior double vertebral column resections (VCRs) and satellite rods placement. This was a young adult case with severe angular thoracolumbar kyphosis of 101 degrees, secondary to anterior segmentation failure from T11 to L1 . There were hemivertebrae at T11 and T12 , and a wedged vertebra at L1 . He received double VCRs at T12 and T11 and instrumented fusion from T6 to L4 via a posterior only approach. Autologous grafts and a cage were placed between the bony surfaces of the osteotomy gap. Once closure of osteotomy was achieved, bilateral permanent CoCr rods were placed with addition of satellite rods. Postoperative X-ray demonstrated marked correction of kyphosis. On the 10(th) days after surgery, the patient was able to walk without assistance. In conclusion, double VCRs are effective to correct severe angular kyphosis, and addition of satellite rods may be imperative to enhance instrumentation strength and thus prevent correction loss.

Keywords: Satellite rod; Three-column osteotomy; Vertebral column resection; congenital kyphosis.

Figure 1

Radiographs of a 21‐year‐old man with marked kyphosis secondary to thoracolumbar anomalies. (A) There are hemivertebrae at T₁₁ and T₁₂, and a wedged vertebra at L₁. They converge anteriorly, thus separating the posterior column. (B) A transverse plane of a vertebra (L₂) is clearly visible in this standing posteroanterior film. After double VCRs at T₁₁ and T₁₂ and use of satellite rods, (C) kyphosis was satisfactorily corrected and (D) balance well maintained.