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Comparison of anterior and posterior vertebral column resection versus anterior release with posterior internal distraction for severe and rigid scoliosis

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Abstract

Purpose

This study aimed to compare efficacy, safety, and cost between staged vertebral column resection (VCR) and anterior release with internal distraction in treating severe and rigid idiopathic scoliosis.

Methods

We examined the records of 43 patients with severe and rigid idiopathic scoliosis treated in our hospital. Group A included 26 patients who underwent anterior VCR followed by posterior vertebral column resection and instrumentation from July 2007 to October 2009. Group B included 17 patients who underwent anterior release with temporary posterior internal distraction, followed by posterior fusion and instrumentation from November 2009 to June 2011. The average preoperative main curve for group A was 101.3° (range 90°–130°) and for group B was 104.8° (range 90°–136°). Minimum follow-up was 2 years. Radiographic and clinical outcomes were compared between the groups.

Results

A t test demonstrated that the differences between the groups in preoperative and postoperative coronal and sagittal imbalance, thoracic kyphosis correction, and lumbar lordosis were not statistically significant. Patients in group B showed better postoperative (P = 0.031) and final (P = 0.030) main thoracic curve correction (76.8 and 75.6 %, respectively) than patients in group A (68.3 and 67.7 %, respectively). Patients in group B had better thoracolumbar or lumbar curve correction (85.8 %) than those in group A (76.8 %; P = 0.048). The differences in blood loss and operation time were not statistically significant (P = 0.094 and P = 0.060, respectively). Hospital stay was longer (P = 0.001) and patient cost was higher (P < 0.001) for patients in group B. One patient in group A required ventilator support for 12 h after anterior surgery. One transient dyspnea occurred in group B. No neurologic deficits occurred in either group.

Conclusion

Anterior release with posterior internal distraction produces better corrective effects than anterior and posterior VCR, though hospital stay and costs are greater.

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References

  1. Bullmann V, Halm HF, Schulte T, Lerner T, Weber TP, Liljenqvist UR (2006) Combined anterior and posterior instrumentation in severe and rigid idiopathic scoliosis. Eur Spine J 15:440–448

    Article  PubMed Central  PubMed  Google Scholar 

  2. Byrd JA 3rd, Scoles PV, Winter RB, Bradford DS, Lonstein JE, Moe JH (1987) Adult idiopathic scoliosis treated by anterior and posterior spinal fusion. J Bone Joint Surg Am 69:843–850

    PubMed  Google Scholar 

  3. Klockner C, Walter G, Matussek J, Weber U (2000) Ventrodorsal correction and instrumentation in idiopathic scoliosis. Orthopade 29:571–577

    Article  CAS  PubMed  Google Scholar 

  4. Shen J, Qiu G, Wang Y, Zhang Z, Zhao Y (2006) Comparison of 1-stage versus 2-stage anterior and posterior spinal fusion for severe and rigid idiopathic scoliosis—a randomized prospective study. Spine 31:2525–2528

    Article  PubMed  Google Scholar 

  5. Zhou CG, Liu LM, Song YM, Liu H, Li T, Kong QQ (2011) Anterior and posterior vertebral column resection for severe and rigid idiopathic scoliosis. Eur Spine J 20:1728–1734

    Article  PubMed Central  PubMed  Google Scholar 

  6. Toledo LC, Toledo CH, MacEwen GD (1982) Halo traction with the circolectric bed in the treatment of severe spinal deformities: a preliminary report. J Pediatr Orthop 2:554–559

    Article  CAS  PubMed  Google Scholar 

  7. Mehlman CT, Al–Sayyad MJ, Crawford AH (2004) Effectiveness of spinal release and halo-femoral traction in the management of severe spinal deformity. J Pediatr Orthop 24:667–673

    Article  PubMed  Google Scholar 

  8. Rinella A, Lenke L, Whitaker C, Kim Y, Park SS, Peelle M (2005) Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine 30:475–482

    Article  PubMed  Google Scholar 

  9. Koller H, Zenner J, Gajic V, Meier O, Ferraris L, Hitzl W (2012) The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature. Eur Spine J 21:514–529

    Article  PubMed Central  PubMed  Google Scholar 

  10. Watanabe K, Lenke LG, Bridwell KH, Kim YJ, Hensley M, Koester L (2010) Efficacy of perioperative halo-gravity traction for treatment of severe scoliosis (O/5100 degrees). J Orthop Sci 15:720–730

    Article  PubMed  Google Scholar 

  11. Park DK, Braaksma B, Hammerberg KW, Sturm P (2013) The efficacy of preoperative halo-gravity traction in pediatric spinal deformity the effect of traction duration. J Spinal Disord Tech 26:146–154

    Article  PubMed  Google Scholar 

  12. Bridwell KH (2006) Decision making regarding Smith-Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine 31:S171–S178

    Article  PubMed  Google Scholar 

  13. Lenke LG, O’ Leary PT, Bridwell KH (2009) Posterior vertebral column resection for severe pediatric deformity: minimum two-year follow-up of thirty-five consecutive patients. Spine 34:2213–2221

    Article  PubMed  Google Scholar 

  14. Lenke LG, Sides BA, Koester LA, Hensley M, Blanke KM (2010) Vertebral column resection for the treatment of severe spinal deformity. Clin Orthop Relat Res 468:687–699

    Article  PubMed Central  PubMed  Google Scholar 

  15. Smith JS, Wang VY, Ames CP (2008) Vertebral column resection for rigid spinal deformity. Neurosurgery 63:177–182

    Article  PubMed  Google Scholar 

  16. Suk SI, Chung ER, Kim JH, Kim SS, Lee JS, Choi WK (2005) Posterior vertebral column resection for severe rigid scoliosis. Spine 30:1682–1687

    Article  PubMed  Google Scholar 

  17. Hamzaoglu A, Alanay A, Ozturk C, Sarier M, Karadereler S, Ganiyusufoglu K (2011) Posterior vertebral column resection in severe spinal deformities: a total of 102 cases. Spine 36:E340–E344

    PubMed  Google Scholar 

  18. Lenke LG, Newton PO, Sucato DJ, Shufflebarger HL, Emans JB, Sponseller PD et al (2013) Complications after 147 consecutive vertebral column resections for severe pediatric spinal deformity. Spine 38:119–132

    Article  PubMed  Google Scholar 

  19. Jeszenszky D, Haschtmann D, Kleinstuck FS, Sutter M, Eggspuhler A, Weiss M et al (2013) Posterior vertebral column resection in early onset spinal deformities. Eur Spine J 23(1):198–208

    Article  PubMed  Google Scholar 

  20. Grass PJ, Soto AV, Araya Hp (1997) Intermittent distracting rod for correction of high neurologic risk congenital scoliosis. Spine (Phila Pa 1976) 22(16):1922–1927

    Article  CAS  Google Scholar 

  21. Buchowski JM, Bhatnagar R, Skaggs DL, Sponseller PD (2006) Temporary internal distraction asan aid to correction of severe scoliosis. J Bone Joint Surg Am 88:2035–2041

    Article  PubMed  Google Scholar 

  22. Enercan M, Ozturk C, Kahraman S, Sarıer M, Hamzaoglu A, Alanay A (2013) Osteotomies/spinal column resections in adult deformity. Eur Spine J 22(Suppl 2):S254–S264

    Article  PubMed  Google Scholar 

  23. Sponseller PD, Takenaga RK, Newton P, Boachie O, Flynn J, Letko L (2008) The use of traction in the treatment of severe spinal deformity. Spine 33(21):2305

    Article  PubMed  Google Scholar 

  24. MacLennan A (1922) Scoliosis. Br Med J 2:865–866

    Google Scholar 

  25. Bradford DS, Tribus CB (1997) Vertebral column resection for the treatment of rigid coronal decompensation. Spine 22:1590–1599

    Article  CAS  PubMed  Google Scholar 

  26. Xie JM, Li T, Wang YS, Zhao Z, Zhang Y, Bi N (2012) Change in Cobb angle of each segment of the major curve after posterior vertebral column resection (PVCR): a preliminary discussion of correction mechanisms of PVCR. Eur Spine J 21:705–710

    Article  PubMed Central  PubMed  Google Scholar 

  27. Koptan W, EIMiligui Y (2012) Three-staged correction of severe rigid idiopathic scoliosis using limited halo-gravity traction. Eur Spine J 21(6):1091–1098

    Article  PubMed Central  PubMed  Google Scholar 

  28. Li C, Fu QS, Zhou Y, Yu HY, Zhao G (2012) Posterior extrapleural intervertebral space release combined with wedge osteotomy for the treatment of severe rigid scoliosis. Spine 37:E647–E654

    Article  PubMed  Google Scholar 

  29. Tan R, Ma HS, Zou DW, Wu JG, Chen ZM, Zhou XF (2012) Surgical treatment of severe scoliosis and kyphoscoliosis by stages. Chin Med J 125(1):81–86

    PubMed  Google Scholar 

  30. Cheng XF, Ma HS, Tan R, Wu JG, Zhou JW, Zou DW (2012) Two-stage posterior-only procedures for correction of severe spinal deformities. Arch Orthop Trauma Surg 132:193–201

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors did not receive any funding.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 37 Guoxue Rd, Chengdu, 610041, People’s Republic of China

    Chunpeng Ren, Limin Liu, Yueming Song, Chunguang Zhou, Hao Liu & Tao Li

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  1. Chunpeng Ren
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  2. Limin Liu
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  3. Yueming Song
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  4. Chunguang Zhou
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  5. Hao Liu
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  6. Tao Li
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Correspondence to Limin Liu.

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Ren, C., Liu, L., Song, Y. et al. Comparison of anterior and posterior vertebral column resection versus anterior release with posterior internal distraction for severe and rigid scoliosis. Eur Spine J 23, 1237–1243 (2014). https://doi.org/10.1007/s00586-014-3270-6

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  • DOI: https://doi.org/10.1007/s00586-014-3270-6

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