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Asian Spine J. 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.

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  • 1Department of Orthopaedics, Seoul Spine Institute, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

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

PMID:
23275809
[PubMed]
PMCID:
PMC3530700
Free PMC Article
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