Vertebral Column

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Keith H Bridwell - One of the best experts on this subject based on the ideXlab platform.

  • decision making regarding smith petersen vs pedicle subtraction osteotomy vs Vertebral Column resection for spinal deformity
    Spine, 2006
    Co-Authors: Keith H Bridwell
    Abstract:

    Study design Author experience and literature review. Objectives To investigate and discuss decision-making on when to perform a Smith-Petersen osteotomy as opposed to a pedicle subtraction procedure and/or a Vertebral Column resection. Summary of background data Articles have been published regarding Smith-Petersen osteotomies, pedicle subtraction procedures, and Vertebral Column resections. Expectations and complications have been reviewed. However, decision-making regarding which of the 3 procedures is most useful for a particular spinal deformity case is not clearly investigated. Methods Discussed in this manuscript is the author's experience and the literature regarding the operative options for a fixed coronal or sagittal deformity. Results There are roles for Smith-Petersen osteotomy, pedicle subtraction, and Vertebral Column resection. Each has specific applications and potential complications. Conclusion As the magnitude of resection increases, the ability to correct deformity improves, but also the risk of complication increases. Therein, an understanding of potential applications and complications is helpful.

Wonkee Choi - One of the best experts on this subject based on the ideXlab platform.

  • posterior Vertebral Column resection for severe rigid scoliosis
    Spine, 2005
    Co-Authors: Se-il Suk, Jin-hyok Kim, Ewy-ryong Chung, Sung-soo Kim, Jungsub Lee, Wonkee Choi
    Abstract:

    Study design Retrospective study. Objective To report on the technique and results of posterior Vertebral Column resection (PVCR) for severe rigid scoliosis. Summary of background data The treatment of severe rigid scoliosis is a demanding surgical challenge. Conventional procedures such as combined anteroposterior instrumentation enable limited correction. In rigid scoliosis, Vertebral Column resection is a better option for accomplishing translation of spinal Column. PVCR is performed through a single posterior approach. Methods A total of 16 patients with scoliosis (average age 29 years) subjected to PVCR were retrospectively reviewed after a minimum follow-up of 2 years (range 2-6.8). The indication for PVCR was scoliosis more than 80 degrees , with flexibility less than 25%. The radiographic parameters were evaluated, and clinical records were reviewed. Results The number of vertebrae removed averaged 1.3, and 21 total (15 thoracic and 6 lumbar). Average fusion extent was 10.6 vertebrae. The mean preoperative scoliosis of 109.0 degrees was corrected to 45.6 degrees (59% correction) at the most recent follow-up, and the minor curve of 59.3 degrees was corrected to 29.2 degrees (51% correction). The mean preoperative coronal imbalance of 4.0 cm was improved to 1.0 cm at the most recent follow-up, and sagittal imbalance of 4.2 cm was improved to 1.6 cm. Complications were encountered in 4 patients, including 1 complete paralysis, 1 hematoma, 1 hemopneumothorax, and 1 proximal junctional kyphosis. Conclusions PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.

Se-il Suk - One of the best experts on this subject based on the ideXlab platform.

  • posterior Vertebral Column resection for severe rigid scoliosis
    Spine, 2005
    Co-Authors: Se-il Suk, Jin-hyok Kim, Ewy-ryong Chung, Sung-soo Kim, Jungsub Lee, Wonkee Choi
    Abstract:

    Study design Retrospective study. Objective To report on the technique and results of posterior Vertebral Column resection (PVCR) for severe rigid scoliosis. Summary of background data The treatment of severe rigid scoliosis is a demanding surgical challenge. Conventional procedures such as combined anteroposterior instrumentation enable limited correction. In rigid scoliosis, Vertebral Column resection is a better option for accomplishing translation of spinal Column. PVCR is performed through a single posterior approach. Methods A total of 16 patients with scoliosis (average age 29 years) subjected to PVCR were retrospectively reviewed after a minimum follow-up of 2 years (range 2-6.8). The indication for PVCR was scoliosis more than 80 degrees , with flexibility less than 25%. The radiographic parameters were evaluated, and clinical records were reviewed. Results The number of vertebrae removed averaged 1.3, and 21 total (15 thoracic and 6 lumbar). Average fusion extent was 10.6 vertebrae. The mean preoperative scoliosis of 109.0 degrees was corrected to 45.6 degrees (59% correction) at the most recent follow-up, and the minor curve of 59.3 degrees was corrected to 29.2 degrees (51% correction). The mean preoperative coronal imbalance of 4.0 cm was improved to 1.0 cm at the most recent follow-up, and sagittal imbalance of 4.2 cm was improved to 1.6 cm. Complications were encountered in 4 patients, including 1 complete paralysis, 1 hematoma, 1 hemopneumothorax, and 1 proximal junctional kyphosis. Conclusions PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.

  • Posterior Vertebral Column resection for severe spinal deformities.
    Spine, 2002
    Co-Authors: Se-il Suk, Jin-hyok Kim, Won-joong Kim, Sang Min Lee, Ewy-ryong Chung, Ki-ho Nah
    Abstract:

    STUDY DESIGN: Retrospective study. OBJECTIVES: To report a technique of Vertebral Column resection through a single posterior approach and its preliminary results in the treatment of moderate to severe spinal deformities with limited flexibility. SUMMARY OF BACKGROUND DATA: Vertebral Column resection is a formidable operation reserved for moderate to severe deformities with limited flexibility. The authors devised a technique of Vertebral Column resection through a single posterior approach that offers significant advantages over the anterior-posterior Vertebral Column resection. METHODS: Seventy spinal deformity patients treated by posterior Vertebral Column resection were reviewed. Minimum follow-up was 2 years (range 2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years at the time of the operation. Etiologic diagnoses were adult scoliosis in 7, congenital kyphoscoliosis in 38, and postinfectious kyphosis in 25. The surgery consisted of temporary stabilization of the Vertebral Column with segmental pedicle screw fixation, resection of the Vertebral Column at the apex of the deformity via the posterior route, followed by gradual deformity correction and global fusion. RESULTS: The total number of resected vertebrae was 143: 76 in thoracic and 67 in lumbar. Mean operation time was 4 hours, 31 minutes with average blood loss of 2333 mL. The deformity correction was 61.9% in the coronal plane and 45.2 degrees in the sagittal plane. Complications were encountered in 24 patients: 2 complete cord injuries in severe adult scoliosis and thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections, and 5 hemopneumothoraxes. CONCLUSIONS: Posterior Vertebral Column resection is an effective alternative for moderate to severe deformities with limited flexibility. However, it is a technically demanding and exhausting procedure with possible risks for major complications.

Jin-hyok Kim - One of the best experts on this subject based on the ideXlab platform.

  • posterior Vertebral Column resection for severe rigid scoliosis
    Spine, 2005
    Co-Authors: Se-il Suk, Jin-hyok Kim, Ewy-ryong Chung, Sung-soo Kim, Jungsub Lee, Wonkee Choi
    Abstract:

    Study design Retrospective study. Objective To report on the technique and results of posterior Vertebral Column resection (PVCR) for severe rigid scoliosis. Summary of background data The treatment of severe rigid scoliosis is a demanding surgical challenge. Conventional procedures such as combined anteroposterior instrumentation enable limited correction. In rigid scoliosis, Vertebral Column resection is a better option for accomplishing translation of spinal Column. PVCR is performed through a single posterior approach. Methods A total of 16 patients with scoliosis (average age 29 years) subjected to PVCR were retrospectively reviewed after a minimum follow-up of 2 years (range 2-6.8). The indication for PVCR was scoliosis more than 80 degrees , with flexibility less than 25%. The radiographic parameters were evaluated, and clinical records were reviewed. Results The number of vertebrae removed averaged 1.3, and 21 total (15 thoracic and 6 lumbar). Average fusion extent was 10.6 vertebrae. The mean preoperative scoliosis of 109.0 degrees was corrected to 45.6 degrees (59% correction) at the most recent follow-up, and the minor curve of 59.3 degrees was corrected to 29.2 degrees (51% correction). The mean preoperative coronal imbalance of 4.0 cm was improved to 1.0 cm at the most recent follow-up, and sagittal imbalance of 4.2 cm was improved to 1.6 cm. Complications were encountered in 4 patients, including 1 complete paralysis, 1 hematoma, 1 hemopneumothorax, and 1 proximal junctional kyphosis. Conclusions PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.

  • Posterior Vertebral Column Resection for Severe Spinal Deformities
    The Journal of The Korean Orthopaedic Association, 2003
    Co-Authors: Il Suk, Jin-hyok Kim, Sang Min Lee, Ewy-ryong Chung, Seong Tae Cho, Jung-hee Lee, Sung-soo Kim, Chang Hyun Nam, Hyun Ho Kim, Chang Soo Lee
    Abstract:

    Purpose : To report a technique of Vertebral Column resection using a single posterior approach and its results in the treatment of severe spinal deformities. Materials and Methods : Seventy spinal deformity patients treated by posterior Vertebral Column resection (PVCR) were retrospectively reviewed with minimum follow up of 2 years (2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years. Etiologic diagnoses were; adult scoliosis in 7, congenital kyphoscoliosis in 38, and post-infectious kyphosis in 25. The surgery consisted of temporary stabilization of the Vertebral Column with segmental pedicle screw fixation, resection of the Vertebral Column at the apex of the deformity via the posterior route followed by gradual deformity correction and fusion. Radiological and clinical data were reviewed for deformity correction and clinical results. Results : The total number of resected vertebrae were 143; 76 thoracic and 67 lumbar. Mean operation time was 4 hours 31 minutes with an average blood loss of 2,333 mL. The deformity correction was 62.9% in the coronal plane and in the sagittal plane. Complications were encountered in 24 patients; 2 complete cord injuries in severe adult scoliosis and a single thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections and 5 hemopneumothoraxes. Conclusion : PVCR is an effective alternative for severe fixed spinal deformities. However, extreme caution must be taken in patients with preoperative cord compromise who have a high risk of neurological complications.

  • Posterior Vertebral Column resection for severe spinal deformities.
    Spine, 2002
    Co-Authors: Se-il Suk, Jin-hyok Kim, Won-joong Kim, Sang Min Lee, Ewy-ryong Chung, Ki-ho Nah
    Abstract:

    STUDY DESIGN: Retrospective study. OBJECTIVES: To report a technique of Vertebral Column resection through a single posterior approach and its preliminary results in the treatment of moderate to severe spinal deformities with limited flexibility. SUMMARY OF BACKGROUND DATA: Vertebral Column resection is a formidable operation reserved for moderate to severe deformities with limited flexibility. The authors devised a technique of Vertebral Column resection through a single posterior approach that offers significant advantages over the anterior-posterior Vertebral Column resection. METHODS: Seventy spinal deformity patients treated by posterior Vertebral Column resection were reviewed. Minimum follow-up was 2 years (range 2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years at the time of the operation. Etiologic diagnoses were adult scoliosis in 7, congenital kyphoscoliosis in 38, and postinfectious kyphosis in 25. The surgery consisted of temporary stabilization of the Vertebral Column with segmental pedicle screw fixation, resection of the Vertebral Column at the apex of the deformity via the posterior route, followed by gradual deformity correction and global fusion. RESULTS: The total number of resected vertebrae was 143: 76 in thoracic and 67 in lumbar. Mean operation time was 4 hours, 31 minutes with average blood loss of 2333 mL. The deformity correction was 61.9% in the coronal plane and 45.2 degrees in the sagittal plane. Complications were encountered in 24 patients: 2 complete cord injuries in severe adult scoliosis and thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections, and 5 hemopneumothoraxes. CONCLUSIONS: Posterior Vertebral Column resection is an effective alternative for moderate to severe deformities with limited flexibility. However, it is a technically demanding and exhausting procedure with possible risks for major complications.

Ewy-ryong Chung - One of the best experts on this subject based on the ideXlab platform.

  • posterior Vertebral Column resection for severe rigid scoliosis
    Spine, 2005
    Co-Authors: Se-il Suk, Jin-hyok Kim, Ewy-ryong Chung, Sung-soo Kim, Jungsub Lee, Wonkee Choi
    Abstract:

    Study design Retrospective study. Objective To report on the technique and results of posterior Vertebral Column resection (PVCR) for severe rigid scoliosis. Summary of background data The treatment of severe rigid scoliosis is a demanding surgical challenge. Conventional procedures such as combined anteroposterior instrumentation enable limited correction. In rigid scoliosis, Vertebral Column resection is a better option for accomplishing translation of spinal Column. PVCR is performed through a single posterior approach. Methods A total of 16 patients with scoliosis (average age 29 years) subjected to PVCR were retrospectively reviewed after a minimum follow-up of 2 years (range 2-6.8). The indication for PVCR was scoliosis more than 80 degrees , with flexibility less than 25%. The radiographic parameters were evaluated, and clinical records were reviewed. Results The number of vertebrae removed averaged 1.3, and 21 total (15 thoracic and 6 lumbar). Average fusion extent was 10.6 vertebrae. The mean preoperative scoliosis of 109.0 degrees was corrected to 45.6 degrees (59% correction) at the most recent follow-up, and the minor curve of 59.3 degrees was corrected to 29.2 degrees (51% correction). The mean preoperative coronal imbalance of 4.0 cm was improved to 1.0 cm at the most recent follow-up, and sagittal imbalance of 4.2 cm was improved to 1.6 cm. Complications were encountered in 4 patients, including 1 complete paralysis, 1 hematoma, 1 hemopneumothorax, and 1 proximal junctional kyphosis. Conclusions PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.

  • Posterior Vertebral Column Resection for Severe Spinal Deformities
    The Journal of The Korean Orthopaedic Association, 2003
    Co-Authors: Il Suk, Jin-hyok Kim, Sang Min Lee, Ewy-ryong Chung, Seong Tae Cho, Jung-hee Lee, Sung-soo Kim, Chang Hyun Nam, Hyun Ho Kim, Chang Soo Lee
    Abstract:

    Purpose : To report a technique of Vertebral Column resection using a single posterior approach and its results in the treatment of severe spinal deformities. Materials and Methods : Seventy spinal deformity patients treated by posterior Vertebral Column resection (PVCR) were retrospectively reviewed with minimum follow up of 2 years (2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years. Etiologic diagnoses were; adult scoliosis in 7, congenital kyphoscoliosis in 38, and post-infectious kyphosis in 25. The surgery consisted of temporary stabilization of the Vertebral Column with segmental pedicle screw fixation, resection of the Vertebral Column at the apex of the deformity via the posterior route followed by gradual deformity correction and fusion. Radiological and clinical data were reviewed for deformity correction and clinical results. Results : The total number of resected vertebrae were 143; 76 thoracic and 67 lumbar. Mean operation time was 4 hours 31 minutes with an average blood loss of 2,333 mL. The deformity correction was 62.9% in the coronal plane and in the sagittal plane. Complications were encountered in 24 patients; 2 complete cord injuries in severe adult scoliosis and a single thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections and 5 hemopneumothoraxes. Conclusion : PVCR is an effective alternative for severe fixed spinal deformities. However, extreme caution must be taken in patients with preoperative cord compromise who have a high risk of neurological complications.

  • Posterior Vertebral Column resection for severe spinal deformities.
    Spine, 2002
    Co-Authors: Se-il Suk, Jin-hyok Kim, Won-joong Kim, Sang Min Lee, Ewy-ryong Chung, Ki-ho Nah
    Abstract:

    STUDY DESIGN: Retrospective study. OBJECTIVES: To report a technique of Vertebral Column resection through a single posterior approach and its preliminary results in the treatment of moderate to severe spinal deformities with limited flexibility. SUMMARY OF BACKGROUND DATA: Vertebral Column resection is a formidable operation reserved for moderate to severe deformities with limited flexibility. The authors devised a technique of Vertebral Column resection through a single posterior approach that offers significant advantages over the anterior-posterior Vertebral Column resection. METHODS: Seventy spinal deformity patients treated by posterior Vertebral Column resection were reviewed. Minimum follow-up was 2 years (range 2-3.3 years). There were 34 males and 36 females with a mean age of 27.4 years at the time of the operation. Etiologic diagnoses were adult scoliosis in 7, congenital kyphoscoliosis in 38, and postinfectious kyphosis in 25. The surgery consisted of temporary stabilization of the Vertebral Column with segmental pedicle screw fixation, resection of the Vertebral Column at the apex of the deformity via the posterior route, followed by gradual deformity correction and global fusion. RESULTS: The total number of resected vertebrae was 143: 76 in thoracic and 67 in lumbar. Mean operation time was 4 hours, 31 minutes with average blood loss of 2333 mL. The deformity correction was 61.9% in the coronal plane and 45.2 degrees in the sagittal plane. Complications were encountered in 24 patients: 2 complete cord injuries in severe adult scoliosis and thoracic kyphosis patient who had significant preoperative cord compromise, 6 hematomas, 4 root injuries (all incomplete), 5 fixation failures, 2 infections, and 5 hemopneumothoraxes. CONCLUSIONS: Posterior Vertebral Column resection is an effective alternative for moderate to severe deformities with limited flexibility. However, it is a technically demanding and exhausting procedure with possible risks for major complications.