Pediatric Posterior Vertebral Column Resection (PVCR): Before and After Ten Years of Age: Greater Than 10-Year Follow-Up

Abstract

Study Design.A retrospective study.Objective.To compare the surgical outcomes of posterior vertebral column resection (PVCR) and its long-term effects on the deformity correction for congenital scoliosis in children less than 18 years of age.Summary of Background Data.There have been no reports on surgical outcomes that pertain to the timing of surgery for congenital scoliosis in children under age 18 years with long term follow-up.Methods.Forty-five congenital scoliosis patients (N=45) under age 18 at the time of surgery were treated by PVCR. These cases were retrospectively studied and had a minimum 10-year follow-up. We assigned patients into two groups: Group 1 (N=19) patients who had surgery before 10 years of age, Group 2 (N=26) patients who had surgery after 10 years of age.Results.In Group 1, the mean Cobb angle of the main curve was 44 degrees before surgery, 10.2 degrees after surgery, and 14.2 degrees at last follow-up. In Group 2, the mean Cobb angle of the main curve was 48.7 degrees before surgery, 17.2 degrees after surgery, and 20.4 degrees at the last follow-up. The mean operative time was 189minutes in Group 1 and 245minutes in Group 2. The mean estimated blood loss (EBL) per kilogram was 52.9mL/kg in Group 1 and 48.1mL/kg in Group 2. There were 22 complications for PVCR and the overall prevalence of complications was 48.9%.Conclusion.PVCR is an effective procedure for the management of congenital scoliosis under age 18. PVCR for congenital scoliosis before the age of 10 years had significantly better deformity correction compared with the group after the age of 10 years and did not cause crankshaft phenomenon.Level of Evidence: 4