[Clinical study on transpedicular spinal osteotomy and vertebrectomy in 125 cases of severe rigid spinal deformity].

OBJECTIVE: A retrospective clinical study of 125 patients with severe rigid spinal deformity who underwent transpedicular spinal osteotomy or vertebrectomy by posterior approach only and correction by posterior segmental instrumentation to analyze the risks of posterior alone osteotomy or vertebrectomy including surgical manipulation, operative time, blood lose, complications, so that to evaluate the safety of this procedure.

METHODS: All patients suffered from severe rigid spinal deformity. In all of these patients, 27 patients were with severe rigid idiopathic scoliosis, 67 with congenital scoliosis, 7 with old spinal fracture, 17 with spinal tuberculosis, 6 with ankylosing spondylosis and 6 with other disorders. Among them, 88 were male and 37 were female with a average age of 21 years. These deformities were corrected by transpedicle spinal osteotomy or vertebrectomy through only posterior approach. Surgical technique was summarized.

RESULTS: A mean surgical time was 210 minutes and blood loss during the procedure was an average of 1400 ml. Intercostal nerve injury occurred in 13 patients with automatic relieve. Dura tearing happened in 6 patients without any neurological problems and healed after removing drainage. Haemothorax and pneumothorax were found in 6 cases during procedure which were healed after 1 week for thoracic drainage. Abdominal skin strain and blister occurred in one patient with ankylosing spondylosis and healed after two weeks. Acute deep wound infection occurred in one case and healed after the treatment of debridement and irrigation. Paraplegia occurred in one patient after surgery and full recovery was noticed after 4 months. The complications occurred principally in earlier stage for this technique.

CONCLUSIONS: In correction of severe rigid spinal deformity, transpedicle spinal osteotomy or vertebrectomy by posterior approach only is safe and the procedure is simple. Complications could be avoided by careful operation.