Abstract:

BACKGROUND: No matter anterior strut-grafting, anterior release combined with posterior correction or posterior wedge osteotomy, can not treat severe spinal angular deformity effectively.
OBJECTIVE: To summarize the clinical experience of the posterior vertebral column resection (PVCR) in the treatment of angular scoliosis and kyphosis, and to discuss the influence about spinal cord.
METHODS: From 2004 October to 2008 December, 15 patients with severe rigid angular kyphosis and scoliosis treated by PVCR were retrospective analyzed. The major curve of all cases in the coronal or/and sagittal plane > 100°, and flexibility less than 10%. There were 2 patients with spinal cord injury and Frankel grade D. Other cases was E. A thorough rib and transverse process resection of the exposed posterior vertebral column was performed. The top segments vessel was ligated and completely resection with the apex to correction. The temporary rods were exchanged alternately. In the process, somatosensory-evoked potentials and eurogenic mixed-evoked potentials (NMEPs) were not used. The Cobb angle correction and neural function changes were compared. 
RESULTS AND CONCLUSION: Average (3.8±1.4) segment vessels were cut in the operation. Deformity correction was 60.8% in the coronal plane and72.9% in the sagital plane. Patients were follow-up for 6-48 months, and all patients Frankel grade was E. Part of patients had muscle tension and anal sphincter muscle relaxation recovered to normal. No grafting shedding or loosening occurred. PVCR is an effective alternative and can obtain good correction for severe rigid angular kyphoscoliosis patients. In the stable mechanical and look, spinal cord can tolerate appropriate short, angles and displacement. Through circumferential decompression, and keep spinal cord isotonic and appropriate short, spinal cord function will recover.