Outcome of single stage vertebral column resection in treatment of kyphotic deformity.

OBJECTIVE: To find the frequency of deformity correction, functional outcome and complications of single-stage vertebral column resection in patients with kyphotic deformity. METHODS: The prospective case series was conducted at Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from January 2012 to December 2013, and comprised all patients who underwent single-stage posterior vertebral column resection. Only patients with severe rigid sharp deformity of different aetiology that required more than 40 degree correction and who had at least 3-month follow-up were included. Data was processed using SPSS 16. RESULTS: Of the total 18 patients, 11(61.1%) were male and 7(38.9%) were female, with an overall mean age of 28.7±13.6 years (range: 12-60 years). Among them, 8(44.4%) patients had congenital kyphosis, 5(27.8%) had posttraumatic origin, 4(22.2%) had post-tuberculous deformity, while 1(5.6%) had iatrogenic kyphosis. The apex of the deformity was in thoracic spine in 12(66.7%) patients, while in 6(33.3%) patients it was in the lumbar spine. The average pre- and post-operative Cobb's angle was 66.2±18.9 degrees and 18.8±12.8 degrees respectively. Mean correction of deformities was 47.3±13.3 degrees. The mean correction achieved in percentage terms was 73.5±8.6 per cent (range: 56-87%). There were no patients with post-operative deterioration of neurological status. Two (11%) patients underwent re-exploration of the wounds with wash and cultures due to wound discharge. CONCLUSIONS: Posterior vertebral column resection was found to be a very effective method of correction of severe kyphotic deformities in expert hands with acceptable morbidity.