Posterior Vertebral Column Resection for Pediatric Rigid Spinal Deformity Publisher Pubmed



Ouldslimane M¹ ; Hossein Nabian M² ; Simon AL³ ; Happiette A³ ; Julienmarsollier F⁴ ; Ilharreborde B³
Source: Orthopaedics and Traumatology: Surgery and Research Published:2022

Abstract

Introduction: Surgery for pediatric spinal deformity may involve vertebral osteotomies in complex cases. Vertebral column resection (VCR) is the most technically demanding procedure, with the severest morbidity. It can use a double anterior and posterior approach (APVCR), though a single posterior approach (PVCR) is gaining in popularity. Hypothesis: PVCR provides effective correction with acceptable morbidity in children. Method: A single-center retrospective series included spinal deformities treated by PVCR. Surgical data and global pelvic-spinal balance parameters were analyzed. Results: Sixteen PVCRs were performed in 13 patients, with a mean age of 14.1 ± 2.8 years. Mean operative time was 411 ± 54 minutes. Mean preoperative rigid principal Cobb angle was 74.3°. Mean correction was 64.3% postoperatively, without significant correction loss at last follow-up. Mean blood loss was 941 ± 221 ml. The cell-saver enabled 92.3% autologous transfusions, with 53.4% homologous transfusions. Transient monoplegia and permanent psoas deficit were observed during the postoperative period. Radiologic follow-up found 4 non-unions requiring revision. Conclusion: PVCR provided major correction of rigid spinal deformity in children. Complications mainly comprised mechanical or neurological incidents. Level of evidence: IV, non-comparative cohort study. © 2020 Elsevier Masson SAS