A study published in Spine Deformity, the official journal of the Scoliosis Research Society, examines patients undergoing primary and revision vertebral column resection to compare correction rates and complications.
The article includes data from patients who underwent posterior-only vertebral column resection. There are 55 patients included in the study and all patients had a minimum of two-year follow-ups. The average number of VCR levels was 1.6 in the revision patients, compared to 1.2 in the primary cases.
Here are five findings from the study:
1. Patients who had severe scoliosis and kyphoscoliosis experienced major coronal curve correction in 48 percent of the revision cases and 63 percent of the primary cases.
2. The major sagittal curve correction was 52 percent in the revision cases for patients with kyphoscoliosis, global kyphosis and angular kyphosis. The sagittal curve correction was 57 percent for these patients undergoing primary surgery.
3. There was significantly greater preoperative and postoperative sagittal imbalance in the revision group. The preoperative and postoperative Scoliosis Research Society scores were not significantly different between the groups.
4. None of the patients reported spinal cord-related complications, but around 13 percent in the revision group and 8 percent in the primary group temporarily lost neuromonitoring data or failed wake-up tests. None of these patients had permanent neurological deficit.
5. There were six revision patients — or 11 percent — who required further revision surgery:
• Implant failure: 3 patients
• Progressive sagittal or coronal imbalance: 2
• Delayed deep wound infection: 1
At the same time, there was only one primary patient who had additional surgery. The additional procedure was due to an increased coronal imbalance.
"Vertebral column resections in revision patients may be more technically demanding than in primary patients but can be performed safely in conjunction with intraoperative spinal cord monitoring," the study authors concluded. "Revision and primary patients undergoing VCR showed improved clinical outcomes."