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Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar Kyphosis in Patients With Achondroplasia
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: We aimed to evaluate the safety and validity of posterior vertebral column resection (pVCR) for severe thoracolumbar kyphosis (TLK) in the achondroplasia (ACH) patients. METHODS: Seven ACH patients (male: female = 6:1) who underwent pVCR procedure...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9609545/ https://www.ncbi.nlm.nih.gov/pubmed/33611986 http://dx.doi.org/10.1177/2192568221989291 |
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author | Wang, Hai Wang, Shengru Wu, Nan Wang, Shujie Qiu, Guixing Zhang, Jianguo |
author_facet | Wang, Hai Wang, Shengru Wu, Nan Wang, Shujie Qiu, Guixing Zhang, Jianguo |
author_sort | Wang, Hai |
collection | PubMed |
description | STUDY DESIGN: Retrospective cohort study. OBJECTIVE: We aimed to evaluate the safety and validity of posterior vertebral column resection (pVCR) for severe thoracolumbar kyphosis (TLK) in the achondroplasia (ACH) patients. METHODS: Seven ACH patients (male: female = 6:1) who underwent pVCR procedures due to severe TLK from December 2008 to December 2017 in the authors’ hospital were included in this retrospective study. Their mean follow-up duration was 67 ± 35 months. Their clinical characteristics, radiologic characteristics, surgical characteristics and surgical complications were reviewed. RESULTS: A total of 8 vertebrae were removed with an average of 5 ± 2 levels of decompression and 9 ± 2 segments instrumented. The mean correction rates of TLKs and the main curves were 73 ± 15% and 87 ± 6%, respectively. Five patients (71%) had preoperative neurological symptoms with a mean Japanese Orthopedic Association (JOA) score of 8 ± 3 points. Their neurological functions were all improved, with a recovery rate of 78 ± 32% for the JOA score at the last follow-up. Four patients (57%) suffered from surgical complications, including rod breakages (43%), neurological complications (28%), dural tears (14%), cerebrospinal fluid leaks (14%) and proximal junction kyphosis (14%). CONCLUSIONS: pVCR can offer a good correction for TLK and improve neurological function with extensive laminectomies in ACH patients. But the morbidity of surgical complications is relatively high. Therefore, it is a reserved surgical option for severe TLK in ACH patients by experienced spinal surgeons, especially with apical markedly hypoplastic vertebrae. |
format | Online Article Text |
id | pubmed-9609545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-96095452022-10-28 Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar Kyphosis in Patients With Achondroplasia Wang, Hai Wang, Shengru Wu, Nan Wang, Shujie Qiu, Guixing Zhang, Jianguo Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVE: We aimed to evaluate the safety and validity of posterior vertebral column resection (pVCR) for severe thoracolumbar kyphosis (TLK) in the achondroplasia (ACH) patients. METHODS: Seven ACH patients (male: female = 6:1) who underwent pVCR procedures due to severe TLK from December 2008 to December 2017 in the authors’ hospital were included in this retrospective study. Their mean follow-up duration was 67 ± 35 months. Their clinical characteristics, radiologic characteristics, surgical characteristics and surgical complications were reviewed. RESULTS: A total of 8 vertebrae were removed with an average of 5 ± 2 levels of decompression and 9 ± 2 segments instrumented. The mean correction rates of TLKs and the main curves were 73 ± 15% and 87 ± 6%, respectively. Five patients (71%) had preoperative neurological symptoms with a mean Japanese Orthopedic Association (JOA) score of 8 ± 3 points. Their neurological functions were all improved, with a recovery rate of 78 ± 32% for the JOA score at the last follow-up. Four patients (57%) suffered from surgical complications, including rod breakages (43%), neurological complications (28%), dural tears (14%), cerebrospinal fluid leaks (14%) and proximal junction kyphosis (14%). CONCLUSIONS: pVCR can offer a good correction for TLK and improve neurological function with extensive laminectomies in ACH patients. But the morbidity of surgical complications is relatively high. Therefore, it is a reserved surgical option for severe TLK in ACH patients by experienced spinal surgeons, especially with apical markedly hypoplastic vertebrae. SAGE Publications 2021-02-22 2022-10 /pmc/articles/PMC9609545/ /pubmed/33611986 http://dx.doi.org/10.1177/2192568221989291 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Wang, Hai Wang, Shengru Wu, Nan Wang, Shujie Qiu, Guixing Zhang, Jianguo Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar Kyphosis in Patients With Achondroplasia |
title | Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar
Kyphosis in Patients With Achondroplasia |
title_full | Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar
Kyphosis in Patients With Achondroplasia |
title_fullStr | Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar
Kyphosis in Patients With Achondroplasia |
title_full_unstemmed | Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar
Kyphosis in Patients With Achondroplasia |
title_short | Posterior Vertebral Column Resection (pVCR) for Severe Thoracolumbar
Kyphosis in Patients With Achondroplasia |
title_sort | posterior vertebral column resection (pvcr) for severe thoracolumbar
kyphosis in patients with achondroplasia |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9609545/ https://www.ncbi.nlm.nih.gov/pubmed/33611986 http://dx.doi.org/10.1177/2192568221989291 |
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