Materials and Methods: Vertebral Column Resection (VCR) for Severe Pediatric and Adult Spinal Deformity

Kathy M. Blanke, RN
Washington University School of Medicine
St. Louis, MO

Scoliosis Research Society Paper 13
42nd Annual Meeting
Edinburgh, Scotland
September 5-8, 2007

Material and Methods
Between 2002 and 2006, 43 consecutive pediatric and adult severe spinal deformity patients underwent a posterior-only vertebral column resection (VCR) performed by a single surgeon. Indications for surgery were severe and/or rigid spinal deformity divided into four categories: 1) scoliosis (n=7, mean 85°, range 45-150°); 2) global kyphosis (n=12, mean +92°, range 70 to +120°); 3) angular kyphosis (n=10, mean +72°, range 43 to +135°); and 4) combined kyphoscoliosis (n=14, mean total kyphosis + scoliosis 193°, range 149-275°). The diagnoses for the scoliosis patients included idiopathic-4, neuromuscular-1, and congenital-2. The diagnoses for the global kyphosis patients included Scheuermann's-3, congenital-3, and neuromuscular-2, arthrogryposis-1, post-vertebroplasty collapse-1, post-traumatic-1, Klippel-Feil-1. The diagnoses for the angular kyphosis patients included neurofibromatosis-2, congenital dislocations of the spine-2, congenital kyphosis-2, neuromuscular-2, post-laminectomy kyphosis-1, and post-radiation-1. Lastly, the diagnoses for the kyphoscoliosis patients included idiopathic-7, neuromuscular-3, congenital-2, and neurofibromatosis-2.

There were 31 pediatric patients (average age 13, range 4-18 years) and 12 adult patients (average age 52, range 20-73). Patients underwent a one-level (n=25), two-level (n=13), or three-level (n=5) posterior VCR. The majority of the procedures (40 out of 43, 90%) were performed at the L1 or cephalad region of the spinal cord. The remaining three procedures were performed in the upper cauda equina region (L2 and/or L3). Table 1 includes specific demographic details on all patients, while table 2 includes corresponding radiographic data.

Table 1: Demographic Data on 43 Patients

Table 2: Radiographic Data on 43 Patients