Abstract
PURPOSE: The purpose of this study is to review our operative experience of congenital kyphosis or kyphoscoliosis undergoing either pedicle subtraction osteotomy (PSO) or posterior vertebral column resection (pVCR) according to certain criteria we have established. METHODS: From December 2003 to 2009, 23 consecutive patients of congenital kyphosis or kyphoscoliosis were treated by means of PSO or pVCR procedure in a single institution. The average preoperative kyphosis angle was 74.3º. The C7 plumb line was 12.6 mm posterior to the posterior-superior corner of S1 on average, showing negative imbalance. In the 11 cases who had accompanied scoliosis, the average preoperative scoliosis angle was 42.6º. The average Oswestry Deficiency Index (ODI) for back pain was 14.6 before surgery. Eleven patients had compromise of neurological functions. RESULTS: After PSO or pVCR procedure, the average kyphosis angle decreased to 20.0º, and the accompanied scoliosis also decreased to 15.8º. The average follow-up time after surgery was 34.3 months. At the last follow-up, the average kyphosis corrective rate was 73.7 %, and the average scoliosis corrective rate was 61.7 %. The negative imbalance improved, with the C7 plumb line being 1.5 mm posterior to the posterior-superior corner of S1 on average. After surgery, the average ODI for back pain had 40.6 % improvement, and most patients who had neurological symptoms before surgery had varying degrees of relief. The total satisfactory rate to corrective surgery was 91.3 %. No permanent neurological damage was observed. CONCLUSIONS: If selected appropriately, both PSO and pVCR procedures can achieve compatible and satisfactory correction results in the surgical treatment of congenital kyphosis or kyphoscoliosis.