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

Lawrence G. Lenke, MD

The Jerome J. Gilden Professor of Orthopedic Surgery

Co-Chief Pediatric & Adult Spinal, Scoliosis & Reconstructive Surgery

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

Postoperative Treatment
All patients were rigidly stabilized to allow upright posture immediately after surgery. Most patients sat and dangled on the side of the bed on postoperative day 1, and were out of bed and to a chair by postoperative day 2. A few pediatric patients having soft bone, or those with cervicothoracic constructs were braced for 3 to 4 months after surgery. None of the adult patients were braced after surgery. (Figure 1)

Figure 1A-C. Patient is a 58+7-year-old female with a long-standing kyphoscoliosis and osteoporosis.

Figure 1A. Her preoperative main thoracic scoliosis measured 98°, side-bending to only 76° (25% flexibility) with a +109° kyphosis hyperextending to +68°.

Figure 1B. She underwent a single-staged posterior T10 vertebral column resection (VCR) with PSF from T2 to L4, and anterior cage placement from T9-T11. Her postoperative coronal correction was at 38° (61%), and her sagittal plane correction was to +38° (67%).

Figure 1C. Her pre and postoperative clinical photographs show the excellent restoration of more normal trunk contours following her single-level VCR without any thoracoplasty procedure performed.