The unfolding-correcting technique of 3-dimensional close of spinal canal after posterior vertebral col?鄄umn resection in treatment of severe angular kyphotic deformity

English Keywords:Angular kyphotic deformity  Posterior vertebral column resection  Unfolding-correcting technique  3-dimensional close of spinal canal

English Abstract:

  【Abstract】 Objective：To examine the safety and efficacy of unfolding-correcting technique after posterior vertebral column resection to correct severe angular kyphotic deformity.Method：From June 2004 to May 2008，12 patients with severe angular kyphotic deformity treated surgically were included.There were 4 males and 8 females with an average age of 27.9 years（range，16-42 years old）.There were congenital deformity in 6 patients，old tuberculosis in 3，old fracture in 2，and neurofibromatosis in 1.The local deformity was assessed by the Cobb method，the kyphosis angle was from 82° to 150°，with an average of 107.0°.Ten patients also had scoliosis and the Cobb angle in the coronal plane was mean 52.7°（range，11°-128°）.One of six patients of congenital deformity had preoperative neurologic deficits.One of three tuberculosis cases had preoperative neurologic deficits.According to Frankel grading system，two patients were classified as grade D.All patients were surgically treated with the unfolding-correcting technique of 3-dimensional close of spinal canal after posterior vertebral column resection to correct severe angular kyphotic deformity.Result：The average surgery time was 11.1 hours（7.9-14.7h） and average blood loss was 3866ml（2400-5100ml） and average spinal shortening was 2.1cm（1.6-2.7cm）.The average fusion segments was 12.5 ranging from 7 to 14 segments.The Cobb angle in the sagittal plane was corrected from preoperative 107.0° to postoperative 26.1° with a correction rate of 75.6%.The Cobb angle in the coronal plane was corrected from preoperative 52.7° to postoperative 12.3°，with correction rate 76.7％.76.4% of sagittal trunk shift was corrected.Two cases with preoperative neurologic deficits were recovered from grade D to grade E.All patients were followed up for 9-61 months（mean 25.9 months）.Bony fusion was achieved in all patients.There were no spinal cord injury and correction loss.Conclusion：It is satisfactory to treat severe angular kyphotic deformity with the unfolding-correcting technique of 3-dimensional close of spinal canal after posterior vertebral column resection.The 3-dimensional closing technique can provide a safely closing of spinal canal in the sagittal，coronal and transverse planes at the osteotomic level.