Outcome of single stage vertebral column resection in treatment of kyphotic deformity.

OBJECTIVE To find the frequency of deformity correction, functional outcome and complications of single-stage vertebral column resection in patients with kyphotic deformity. METHODS The prospective case series was conducted at Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from January 2012 to December 2013, and comprised all patients who underwent single-stage posterior vertebral column resection. Only patients with severe rigid sharp deformity of different aetiology that required more than 40 degree correction and who had at least 3-month follow-up were included. Data was processed using SPSS 16. RESULTS Of the total 18 patients, 11(61.1%) were male and 7(38.9%) were female, with an overall mean age of 28.7±13.6 years (range: 12-60 years). Among them, 8(44.4%) patients had congenital kyphosis, 5(27.8%) had posttraumatic origin, 4(22.2%) had post-tuberculous deformity, while 1(5.6%) had iatrogenic kyphosis. The apex of the deformity was in thoracic spine in 12(66.7%) patients, while in 6(33.3%) patients it was in the lumbar spine. The average pre- and post-operative Cobb's angle was 66.2±18.9 degrees and 18.8±12.8 degrees respectively. Mean correction of deformities was 47.3±13.3 degrees. The mean correction achieved in percentage terms was 73.5±8.6 per cent (range: 56-87%). There were no patients with post-operative deterioration of neurological status. Two (11%) patients underwent re-exploration of the wounds with wash and cultures due to wound discharge. CONCLUSIONS Posterior vertebral column resection was found to be a very effective method of correction of severe kyphotic deformities in expert hands with acceptable morbidity.