Anterior and posterior vertebral column resection for severe and rigid idiopathic scoliosis.
Summary of "Anterior and posterior vertebral column resection for severe and rigid idiopathic scoliosis."
A total of 16 patients with severe and rigid idiopathic scoliosis treated by anterior and posterior vertebral column resection (APVCR) were retrospectively reviewed after a minimum follow-up of 2 years. The indication for APVCR was scoliosis more than 90° with flexibility less than 20%. The radiographic parameters were evaluated, and clinical records were reviewed. All patients underwent APVCR with posterior pedicle screw instrumentation in a two-stage surgery. The rib hump was reduced from 7.2 cm preoperatively to 1.8 cm at final follow-up (75% correction). Preoperative curves ranged from 93° to 110° Cobb angle. Coronal plane correction of the major curve averaged 67% with an average loss of correction of 1.4%. The apical vertebral translation of the major curve was corrected by 63.5%. The preoperative coronal imbalance of 0.9 cm (range 0-2.4) was improved to 0.8 cm (range 0.1-1.7) at the most recent follow-up. The preoperative sagittal imbalance of 1.0 cm (range -3.1 to 4.6) was improved to 0.9 cm (range -2.6 to 3.0) at the most recent follow-up. Complications were encountered in four patients. One patient required ventilator support for 12 h after anterior surgery. Malposition of one pedicle screw was found in one patient. Malposition of titanium mesh cage happened to two patients. There were no neurological complications, deep wound infections or pseudarthrosis. APVCR is an effective alternative for severe and rigid idiopathic scoliosis.
Affiliation
Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
Journal Details
This article was published in the following journal.
Name: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the Euro
ISSN: 1432-0932
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21633792
- DOI: http://dx.doi.org/10.1007/s00586-011-1861-z
Medical and Biotech [MESH] Definitions
Longitudinal Ligaments
Two extensive fibrous bands running the length of the vertebral column. The anterior longitudinal ligament (ligamentum longitudinale anterius; lacertus medius) interconnects the anterior surfaces of the vertebral bodies; the posterior longitudinal ligament (ligamentum longitudinale posterius) interconnects the posterior surfaces. The commonest clinical consideration is OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT. (From Stedman, 25th ed)
Ossification Of Posterior Longitudinal Ligament
A calcification of the posterior longitudinal ligament of the spinal column, usually at the level of the cervical spine. It is often associated with anterior ankylosing hyperostosis.
Laminectomy
A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots.
Rectus Abdominis
A long flat muscle that extends along the whole length of both sides of the abdomen. It flexes the vertebral column, particularly the lumbar portion; it also tenses the anterior abdominal wall and assists in compressing the abdominal contents. It is frequently the site of hematomas. In reconstructive surgery it is often used for the creation of myocutaneous flaps. (From Gray's Anatomy, 30th American ed, p491)
Cranial Fossa, Middle
The compartment containing the anterior extremities and half the inferior surface of the temporal lobes (TEMPORAL LOBE) of the cerebral hemispheres. Lying posterior and inferior to the anterior cranial fossa (CRANIAL FOSSA, ANTERIOR), it is formed by part of the TEMPORAL BONE and SPHENOID BONE. It is separated from the posterior cranial fossa (CRANIAL FOSSA, POSTERIOR) by crests formed by the superior borders of the petrous parts of the temporal bones.
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