Treatment of Fixed Lumbosacral Kyphosis by Posterior Vertebral Column Resection: A preliminary report / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: This is a retrospective study evaluating the efficacy of new surgical technique for treatment of fixed lumbosacral kyphosis. OBJECTIVES: To report a new method of vertebral column resection and to determine its efficacy in the treatment of fixed lumbosacral kyphosis. SUMMARY OF BACKGROUND DATA The treatment of fixed severe spinal deformity is very difficult and only a few surgical methods are reported. The vertebral column resection from anterior and posterior is a radical method to treat the severe deformity but it has many problems with anterior and posterior approachs. MATERIALS AND METHODS: A new surgical method of vertebral column resection from posterior approach only(PVCR) was carried out in 5 patients of fixed lumbosacral Tb kyphosis from October 1997 to March 1998. The mean age was 43.4 years(range 35-61 years), and four were female and one male. The average postoperative follow-up period was 5.5 months(ranged from 2 months to 12 months). An average of 2.6 vertebrae was resected. The degree of sagittal curves was measured using the Cobb technique preoperatively and postoperatively. the rejional lumbosacral kyphotic angle and compensatory thoracic curvature from 74 to 712. The sagittal imbalance was measured by distance from C7 plumb line to postero-superior corner of 51 using 14 x 36 inch standing lateral radiograph. RESULTS: The sagittal deformities were corrected from an average of kyphosis 37.4 to lodosis 8.4 at lumbosacral level and from an average of lodosis 31.6 to lodosis 8.2 at thoracic level. The sagittal imbalance was improved from an average of +11.7cm to +2.2cm, for a posterior immigration of 9.5cm. The mean operating time was 334 minutes and with an average blood loss of 4338m1. Complication comprised of motor weakness with deep wound infection in one case and superficial wound infection in another case. The transient hip flexor weakness was seen in all the patients. The hip flexor power recovered in 3-4 weeks. The patient of motor weakness and deep infection showed partial motor improvement and complete wound healing at last 2 month follow-up. CONCLUSION: one-stage posterior vertebral column resection is a promising technique for treatment of the severe fixed lumbosacral kyphosis.