Results of Posterior Vertebral Column Resection: Surgical Modification of Suk Technique

Study Design: Consecutive, retrospective review. Objectives: To evaluate and report a modified posterior vertebral column technique. Methods: We present a retrospective analysis of 20 patients. Patients having severe 3-dimensional deformity with flexibility less than 20% and managed by posterior vertebral body resection (PVCR) between 2011 and 2014 were included in this study. There were 12 female and 8 male patients, with a mean age of 18 year (range = 3-63 years). Results: The average follow-up was 3.5 years (2-5 years). The preoperative coronal plane deformity was 84 degrees (70 degrees to 120 degrees) and corrected to 42 degrees (28 degrees to 68 degrees), showing 60% scoliosis correction. Average preoperative local kyphotic angle was 92 degrees (82 degrees to 110 degrees). Correction rate for kyphosis was 62%. All patients after surgery showed their baseline neurological status, and no complications were encountered. The mean estimated blood loss was 1072mL (350-2000 mL). Thirty-nine percent (33% to 50%) of total blood loss occurred after vertebral body resection, and 61% (50% to 67%) blood loss occurred after the removal of posterior elements. The ratio of estimated blood loss to estimated body blood volume was 26% (range = 19% to 52%). Conclusion: We found that 60% of total bleeding occurs during and after posterior bone resection. Spinal cord is open to possible iatrogenic direct spinal cord injury with surgical instruments for a much shorter period of time compared with the original technique.