Posterior vertebral column resection in fixed lumbosacral deformity.


STUDY DESIGN:Retrospective study. OBJECTIVES:To report the results and the technique of posterior vertebral column resection (PVCR) in fixed lumbosacral deformity. SUMMARY OF BACKGROUND DATA:Fixed lumbosacral deformity has gross imbalance as well as progressive compensatory thoracolumbar deformity because of the absence of a mobile spine caudally. There is no consensus of the surgical treatment of fixed lumbosacral deformity. Fixed lumbosacral deformity can be managed by PVCR, which not only corrects the deformity but also restores the trunk balance by translation of spinal column. METHODS:Twenty-five consecutive fixed lumbosacral deformity patients subjected to PVCR were reviewed after a minimum follow-up of 2 years. The apical vertebra and the ultimately resected vertebra were below L4 in most cases. Etiologic diagnoses were congenital scoliosis in 6, congenital kyphoscoliosis in 3, post-traumatic kyphosis in 2, and postinfectious kyphosis in 14. The average age at the operation was 38 years (range, 2.5-61 years) with a male:female ratio of 7:18. The indication for PVCR was fixed lumbosacral deformities that could not be brought to a reasonable balance on traction or forced side bending. Before surgery, 12 patients (48%) presented with neurologic compromise and 20 patients (80%) presented with intractable back pain. The surgical technique consisted of segmental pedicle screw fixation, decompression of neural structures, and resection of the vertebral column at the apex of the deformity via the posterior route, followed by deformity correction and global fusion. During the resection, all the nerve roots were preserved. RESULTS:Two and one tenth (2.1) vertebrae removed on average (range, 1-5 vertebrae), and 52 in all. The average fusion extent was 4.5 vertebrae (range, 2-8 vertebrae). The anterior column reconstruction was carried out with autogenous bone graft in all patients and additional insertion of titanium mesh in 12. The distal anchor went down to L5 in 4 patients, S1 in 12, and S2 in 9. Preoperative scoliosis of 38 degrees +/- 12 degrees was corrected to 15 degrees +/- 8 degrees (60% correction) at most recent follow-up, and preoperative kyphosis of 35 degrees +/- 25 degrees was corrected to -5 degrees +/- 11 degrees (40 degrees correction). The compensatory coronal curve of 26 degrees was spontaneously corrected to 12 degrees at most recent follow-up. The preoperative thoracic lordosis of -16 degrees was corrected to 4 degrees at most recent follow-up, and the preoperative lumbar kyphosis of 20 degrees was corrected to -17 degrees . Preoperative coronal imbalance of 2.0 cm was improved to 0.9 cm at most recent follow-up, and preoperative sagittal imbalance of 9.3 cm was improved to 4.6 cm. Mean operation time was 280 minutes with a blood loss of 2,810 mL. The preoperative neurologic compromise was improved in all patients, and pain was reduced to less than half of preoperative visual analog analog scale in 17 patients. The following complications were encountered in 5 patients: 2 with transient neurology that spontaneously improved without a sequel within 6 months, 2 with compression fractures at proximal adjacent vertebra, and 1 with pseudarthrosis. CONCLUSIONS:PVCR is an effective procedure for the management of fixed lumbosacral deformity. It provides satisfactory correction and improved functional outcomes. However, it is a technically demanding and exhausting procedure with possible risks for complications.


Spine (Phila Pa 1976)




Suk SI,Chung ER,Lee SM,Lee JH,Kim SS,Kim JH





Has Abstract


2005-12-01 00:00:00
















  • Spinal Gout Without Spinal Symptom in a Junior School Student: A Case Report.

    abstract:STUDY DESIGN:Case report. OBJECTIVE:We report a case of a 16-year-old boy with intermittent and migratory polyarthralgia, who made a diagnostic dilemma. SUMMARY OF BACKGROUND DATA:Spinal involvement without spinal symptom in gout seems to be rare. However, the relationship of spinal gout to symptoms is poorly underst...


    pub_type: 杂志文章


    authors: Wu D,Ma J,Li S,Zhao J,Li L

    更新日期:2018-04-15 00:00:00

  • Factors predicting the result of surgery for lumbar intervertebral disc herniation.

    abstract::The prospective study was undertaken to find out preoperative or perioperative factors predicting the results of the first surgery for lumbar disc herniation. The results were evaluated 1 and 6 months postoperatively using, in addition to the patient evaluation, indices for pain, activities of daily living (ADL), and ...


    pub_type: 杂志文章


    authors: Hurme M,Alaranta H

    更新日期:1987-11-01 00:00:00

  • Anterior surgical management of single-level cervical disc disease: a cost-effectiveness analysis.

    abstract:STUDY DESIGN:Cost-effectiveness analysis with decision analysis and meta-analysis. OBJECTIVE:To determine the relative cost-effectiveness of anterior cervical discectomy with fusion (with autograft, allograft, or spacers), anterior cervical discectomy without fusion (ACD), and cervical disc replacement (CDR) for the t...


    pub_type: 杂志文章,meta分析


    authors: Lewis DJ,Attiah MA,Malhotra NR,Burnett MG,Stein SC

    更新日期:2014-12-01 00:00:00

  • Primary solitary cervical amyloidosis: case report and review of the literature.

    abstract:STUDY DESIGN:A case report and literature review are presented. OBJECTIVE:To describe and review the clinical presentations, characteristic findings from imaging studies, types, differential diagnosis, prognosis, and treatment of amyloidoma arising within the vertebrae. SUMMARY OF BACKGROUND DATA:Amyloidoma can occur...


    pub_type: 杂志文章,评审


    authors: Iplikcioglu AC,Bek S,Gokduman CA,Cosar M,Sav A

    更新日期:2007-01-01 00:00:00

  • Long-term follow-up of lower lumbar fusion patients.

    abstract::To determine the long-term effects of lower lumbar fusion, 94 subjects were catalogued from medical records. They had a lumbar arthrodesis at the third lumbar level or below and their operations were performed before 1964. Twenty-four were not located and 8 were deceased. Sixty-two subjects (72% of available sample) c...


    pub_type: 杂志文章


    authors: Lehmann TR,Spratt KF,Tozzi JE,Weinstein JN,Reinarz SJ,el-Khoury GY,Colby H

    更新日期:1987-03-01 00:00:00

  • Postlaminectomy kyphosis in the skeletally immature achondroplast.

    abstract:STUDY DESIGN:Retrospective review. OBJECTIVES:To determine the risk of postlaminectomy thoracolumbar kyphosis in skeletally immature achondroplasts and evaluate the need for concurrent fusion at multilevel decompression. SUMMARY OF BACKGROUND DATA:Spinal stenosis is a relatively common complication of achondroplasia....


    pub_type: 杂志文章


    authors: Ain MC,Shirley ED,Pirouzmanesh A,Hariri A,Carson BS

    更新日期:2006-01-15 00:00:00

  • Measurement of lumbar lordosis. Evaluation of intraobserver, interobserver, and technique variability.

    abstract:STUDY DESIGN:Sixty radiographs were measured on two separate occasions by three physicians using four different techniques to evaluate the reliability and reproducibility of the measurement of lumbar lordosis. OBJECTIVE:To evaluate clinical methods of measuring lumbar lordosis, determining intraobserver and interobser...


    pub_type: 杂志文章


    authors: Polly DW Jr,Kilkelly FX,McHale KA,Asplund LM,Mulligan M,Chang AS

    更新日期:1996-07-01 00:00:00

  • Internal carotid artery thrombosis after cervical corpectomy.

    abstract:SUMMARY OF BACKGROUND DATA:A 74-year-old man suffered an extensive right hemispheric infarct 72 hours after undergoing anterior corpectomies of the C4 and C5 vertebrae for cervical myelopathy resulting from ossification of the posterior longitudinal ligament. RESULTS:Angiography revealed proximal right internal caroti...


    pub_type: 杂志文章


    authors: Chozick BS,Watson P,Greenblatt SH

    更新日期:1994-10-01 00:00:00

  • Outcomes of disabling cervical spine disorders in compensation injuries. A prospective comparison to tertiary rehabilitation response for chronic lumbar spinal disorders.

    abstract:STUDY DESIGN:A prospective, longitudinal cohort study assessing quantitative socioeconomic outcomes of tertiary rehabilitation for chronically disabled patients with cervical spinal disorders compared with those with more common chronic lumbar spinal disorders. OBJECTIVES:To assess 1-year socioeconomic outcomes of a w...


    pub_type: 杂志文章


    authors: Wright A,Mayer TG,Gatchel RJ

    更新日期:1999-01-15 00:00:00

  • Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain.

    abstract:STUDY DESIGN:A prospective double-blind randomized trial in 31 patients. OBJECTIVES:To assess the clinical efficacy of percutaneous radiofrequency denervation of the lumbar zygapophysial joints in reducing pain, functional disability, and physical impairment in patients with back pain originating from the lumbar zygap...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: van Kleef M,Barendse GA,Kessels A,Voets HM,Weber WE,de Lange S

    更新日期:1999-09-15 00:00:00

  • Lumbar spinal fusion. Surgical rates, costs, and complications.

    abstract:STUDY DESIGN:Literature review. OBJECTIVES:To assess the frequency of lumbar fusion procedures in the United States; changes in the incidence of fusion in the past 12 years; variations in fusion procedure rates among geographic regions of the nation and between the United States and other countries; costs of lumbar fu...


    pub_type: 杂志文章,评审


    authors: Katz JN

    更新日期:1995-12-15 00:00:00

  • The impact of mental processing and pacing on spine loading: 2002 Volvo Award in biomechanics.

    abstract:STUDY DESIGN:The impact of various levels of mental processing and pacing (during lifting) on spine loading was monitored under laboratory conditions. OBJECTIVES:To explore how mental demands and pacing influence the biomechanical response and subsequent spine loading and, to determine whether individual characteristi...


    pub_type: 杂志文章


    authors: Davis KG,Marras WS,Heaney CA,Waters TR,Gupta P

    更新日期:2002-12-01 00:00:00

  • Traumatic lumbosacral spondyloptosis treated five months after injury occurrence: a case report.

    abstract:STUDY DESIGN:A case report. OBJECTIVE:To describe a case of traumatic lumbosacral spondyloptosis and present a literature review. SUMMARY OF BACKGROUND DATA:Traumatic spondyloptosis is a very rare injury caused by high-energy trauma. Eight cases of traumatic spondyloptosis of L5-S1 have been reported, including only ...


    pub_type: 杂志文章,评审


    authors: Wangtaphan W,Oo M,Paholpak P,Wang Z,Sakakibara T,Kasai Y

    更新日期:2012-10-15 00:00:00

  • Tumor necrosis factor-immunoreactive cells and PGP 9.5-immunoreactive nerve fibers in vertebral endplates of patients with discogenic low back Pain and Modic Type 1 or Type 2 changes on MRI.

    abstract:STUDY DESIGN:Immunohistochemistry for tumor necrosis factor (TNF) and protein gene product (PGP) 9.5 in vertebral endplates of patients with discogenic low back pain and Modic Type 1 or Type 2 endplate changes on MRI. OBJECTIVES:To examine whether inflammatory cytokines and nerve in-growth into the vertebral endplate ...


    pub_type: 杂志文章


    authors: Ohtori S,Inoue G,Ito T,Koshi T,Ozawa T,Doya H,Saito T,Moriya H,Takahashi K

    更新日期:2006-04-20 00:00:00

  • Rapid, symptomatic enlargement of a lumbar juxtafacet cyst: case report.

    abstract:STUDY DESIGN:A case is reported in which a 45-year-old man developed cauda equina syndrome caused by enlargement of an L4-L5 juxtafacet cyst diagnosed 4 months earlier. OBJECTIVES:To highlight the short interval that can elapse between the discovery of a juxtafacet cyst and its remarkable progression. SUMMARY OF BACK...


    pub_type: 杂志文章


    authors: Paolini S,Ciappetta P,Santoro A,Ramieri A

    更新日期:2002-06-01 00:00:00

  • Predicting long-term disability in low back injured workers presenting to a spine consultant.

    abstract::Low back pain (LBP) is the most common, costly, and disabling musculoskeletal condition. Although most LBP patients recover within two months, 2-3% eventually develop disabling chronic low back pain (DCLBP). Due to the prevalence of DCLBP problems, models have been developed to predict which acute low back pain patien...


    pub_type: 杂志文章


    authors: Lehmann TR,Spratt KF,Lehmann KK

    更新日期:1993-06-15 00:00:00

  • Digital assessment of MRI for lumbar disc desiccation. A comparison of digital versus subjective assessments and digital intensity profiles versus discogram and macroanatomic findings.

    abstract::During magnetic resonance imaging, a vast amount of digital data on anatomic structures is translated into images, which are then assessed subjectively. The development of an objective, sensitive method to directly assess the digital data would have clear benefits, particularly for clinical research on disc degenerati...


    pub_type: 杂志文章


    authors: Videman T,Nummi P,Battié MC,Gill K

    更新日期:1994-01-15 00:00:00

  • Analysis of 3-dimensional course of the intra-axial vertebral artery for C2 pedicle screw trajectory: a computed tomographic study.

    abstract:STUDY DESIGN:A retrospective radiological study. OBJECTIVE:To analyze the course of intra-axial vertebral artery (IAVA) and evaluate the relationship between the 3-dimensional (3D) courses for IAVA with respect to safe trajectory for C2 pedicle screw (C2PS). SUMMARY OF BACKGROUND DATA:The VA at the level of C2 has a ...


    pub_type: 杂志文章


    authors: Lee SH,Park DH,Kim SD,Huh DS,Kim KT

    更新日期:2014-08-01 00:00:00

  • Transoral anterior decompression and fusion of chronic irreducible atlantoaxial dislocation with spinal cord compression.

    abstract:STUDY DESIGN:In this study, 10 patients with chronic irreducible atlantoaxial dislocation were treated by transoral anterior decompression and fusion. OBJECTIVES:To examine the benefits of the transoral approach, the patients treated with this procedure were compared with the historical control subjects after 2 years ...


    pub_type: 杂志文章


    authors: Subin B,Liu JF,Marshall GJ,Huang HY,Ou JH,Xu GZ

    更新日期:1995-06-01 00:00:00

  • Operative versus nonoperative treatment of leg pain in adults with scoliosis: a retrospective review of a prospective multicenter database with two-year follow-up.

    abstract:STUDY DESIGN:Retrospective review of a prospective, multicenter study. OBJECTIVE:The purpose of this study was to assess the prevalence and severity of leg pain in adults with scoliosis and to assess whether surgery significantly improved leg pain compared with nonoperative management. SUMMARY OF BACKGROUND DATA:Pati...


    pub_type: 杂志文章


    authors: Smith JS,Shaffrey CI,Berven S,Glassman S,Hamill C,Horton W,Ondra S,Schwab F,Shainline M,Fu KM,Bridwell K,Spinal Deformity Study Group.

    更新日期:2009-07-15 00:00:00

  • Global Spinal Alignment in Patients With Cervical Spondylotic Myelopathy.

    abstract:STUDY DESIGN:A prospective radiographic analysis of cervical spondylotic myelopathy (CSM). OBJECTIVE:The aim of this study was to clarify the pathophysiology of CSM, and use the characteristic of global spinal alignment for determining the surgical strategy. SUMMARY OF BACKGROUND DATA:Radiographic evaluation of CSM, ...


    pub_type: 杂志文章


    authors: Yoshida G,Alzakri A,Pointillart V,Boissiere L,Obeid I,Matsuyama Y,Vital JM,Gille O

    更新日期:2018-02-01 00:00:00

  • The effect of dilation of immature pedicles on pullout strength of the screws: Part 2: In vivo study.

    abstract:STUDY DESIGN:Experimental study. OBJECTIVE:To evaluate the biomechanical stability of screws placed in expanded pedicles, and to compare those with the screws placed in the nonexpanded pedicles in an in vivo model. SUMMARY OF BACKGROUND DATA:Pullout strength of a pedicle screw increases as the diameter of the screw g...


    pub_type: 杂志文章


    authors: Yilmaz G,Demirkiran G,Ozkan C,Daglioglu K,Pekmezci M,Alanay A,Yazici M

    更新日期:2009-10-15 00:00:00

  • Routes and incidence of communication of lumbar discs with surrounding neural structures.

    abstract::Several authors have previously reported the complications resulting from contact between a diagnostic or therapeutic agent injected into an intervertebral disc and neural tissue. This study was undertaken to demonstrate the common routes by which, and frequency with which this contact occurs. Of 105 cadaveric interve...


    pub_type: 杂志文章


    authors: MacMillan J,Schaffer JL,Kambin P

    更新日期:1991-02-01 00:00:00

  • Preoperative and postoperative anesthetic and analgesic techniques for minimally invasive surgery of the spine.

    abstract:STUDY DESIGN:A review of methods to optimize anesthesia and analgesia for minimally invasive spine procedures. OBJECTIVE:To provide information to surgeons and anesthesiologists of methods to provide optimal anesthesia and pain control for minimally invasive spine surgery with an emphasis on preoperative planning. SU...


    pub_type: 杂志文章,评审


    authors: Buvanendran A,Thillainathan V

    更新日期:2010-12-15 00:00:00

  • Automatic localization of target vertebrae in spine surgery: clinical evaluation of the LevelCheck registration algorithm.

    abstract:STUDY DESIGN:A 3-dimensional-2-dimensional (3D-2D) image registration algorithm, "LevelCheck," was used to automatically label vertebrae in intraoperative mobile radiographs obtained during spine surgery. Accuracy, computation time, and potential failure modes were evaluated in a retrospective study of 20 patients. OB...


    pub_type: 杂志文章


    authors: Lo SF,Otake Y,Puvanesarajah V,Wang AS,Uneri A,De Silva T,Vogt S,Kleinszig G,Elder BD,Goodwin CR,Kosztowski TA,Liauw JA,Groves M,Bydon A,Sciubba DM,Witham TF,Wolinsky JP,Aygun N,Gokaslan ZL,Siewerdsen JH

    更新日期:2015-04-15 00:00:00

  • The long-term follow-up of surgical treatment for cervical myelopathy with severe nape and upper arm pain caused by the anomalous vertebral artery: case report.

    abstract:STUDY DESIGN:A case of cervical myelopathy with a severe nape and upper arm pain caused by anomalous bilateral vertebral arteries is reported. OBJECTIVE:To report over six and a half years results of a microsurgical decompression for high cervical myelopathy with a severe pain of nape and upper arm resulting from spin...


    pub_type: 杂志文章


    authors: Takei H,Sagae M,Chiba K,Ogino T

    更新日期:2008-08-01 00:00:00

  • Optimization of Scaffolds and Surface-Based Treatments for Orthopedic Applications.

    abstract::Improving spinal fusion by optimizing scaffold and surface engineering is a topic of interest for both surgeons and researchers. Concerns regarding patient safety with off-label use of bone morphogenetic protein (BMP) have increased, and patients are choosing minimally invasive spine surgery to lessen morbidity by avo...


    pub_type: 杂志文章


    authors: Chaput CD

    更新日期:2016-04-01 00:00:00

  • Prevalence and risk factors associated with low back pain among health care providers in a Kuwait hospital.

    abstract:STUDY DESIGN:A cross-sectional survey among health professionals working in a Kuwait hospital. OBJECTIVE:To investigate the prevalence and factors associated with low back pain (LBP). SUMMARY OF BACKGROUND DATA:The literature suggests that health professionals are exposed to occupational risk factors that predispose ...


    pub_type: 杂志文章


    authors: Landry MD,Raman SR,Sulway C,Golightly YM,Hamdan E

    更新日期:2008-03-01 00:00:00

  • Cerebrospinal fluid fistula secondary to dural tear in anterior cervical discectomy and fusion: case report.

    abstract:STUDY DESIGN:A case of cerebrospinal fistula secondary to a dural tear during anterior cervical discectomy and fusion. OBJECTIVES:To report a quite rare complication associated with anterior cervical discectomy and remind the spinal surgeons that this infrequent complication can easily become a very serious one. SUMM...


    pub_type: 杂志文章


    authors: Fountas KN,Kapsalaki EZ,Johnston KW

    更新日期:2005-05-15 00:00:00

  • Peroperative three-dimensional correction of idiopathic scoliosis with the Cotrel-Dubousset procedure.

    abstract:STUDY DESIGN:A peroperative measurement technique based on magnetic fields was used to document the thoracic and lumbar vertebral changes induced by derotation of the concave rod during corrective surgery of idiopathic scoliotic deformities with Cotrel-Dubousset instrumentation. OBJECTIVES:Objective was to accurately ...


    pub_type: 临床试验,杂志文章


    authors: Labelle H,Dansereau J,Bellefleur C,de Guise J,Rivard CH,Poitras B

    更新日期:1995-06-15 00:00:00