Modified posterior vertebral column resection for extremely severe post-tubercular kyphosis in adults: a two-year follow-up.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2025-02-18 DOI:10.1186/s13018-025-05595-5

Jingyu Wang, Xiaohui Wang, Xueying Zhang, Hua Hui, Dingjun Hao

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引用次数: 0

Abstract

Objective: To describe the clinical and radiographic outcomes of patients with severe post-tubercular kyphosis (PTK) in adults who underwent modified posterior vertebral column resection (mPVCR).

Methods: A retrospective analysis was conducted on data from 22 patients with severe PTK who underwent surgical treatment. All patients received a one-stage mPVCR deformity correction. General information, radiological parameters including kyphosis angle (KA) and sagittal vertical axis (SVA), functional outcomes including America Spinal Injury Association (ASIA) grades, Oswestry Disability Index (ODI), Scoliosis Research Society-22 (SRS-22) scores, and complications were recorded.

Results: The mean age of the population was 33.6 ± 11.6 years (range: 18-59 years). The average operation time was 383.2 ± 53.8 min, and the mean intraoperative blood loss was 1652.3 ± 331.8 ml. Significant changes in KA (preoperative: 129.5 ± 17.3° vs. postoperative: 43.7 ± 7.6°; p < 0.001) and SVA (preoperative: 30.9 ± 7.5 mm vs. postoperative: 15.0 ± 4.1 mm; p < 0.001) were observed after the surgery. In addition, the mean SRS-22 scores improved following surgical correction, with the most significant improvement in the self-image domain. The overall complication rate was 36.4%, including 6 non-neurological and 2 neurological complications. Although two patients experienced transient neurological deterioration postoperatively, a significant improvement in patients' ASIA grades and ODI scores was found at final follow-up compared to preoperative values.

Conclusion: Modified PVCR represents a safe surgical option for patients with extremely severe PTK requiring aggressive correction. Delayed resection of the posterior elements may contribute to reducing intraoperative blood loss and iatrogenic spinal cord injury during osteotomy. Appropriate correction, while avoiding overcorrection, is beneficial for decreasing neurologic complications.

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.