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  4. Modified posterior vertebral column resection for extremely severe post-tubercular kyphosis in adults: a two-year follow-up

Modified posterior vertebral column resection for extremely severe post-tubercular kyphosis in adults: a two-year follow-up

Journal of Orthopaedic Surgery and Research, 2025 · DOI: https://doi.org/10.1186/s13018-025-05595-5 · Published: February 10, 2025

ImmunologyOrthopedicsSpinal Disorders

Simple Explanation

This study investigates a modified surgical technique called modified posterior vertebral column resection (mPVCR) for treating severe kyphosis resulting from spinal tuberculosis in adults. The goal of the surgery is to correct the spinal deformity, relieve nerve compression, and improve the patient's quality of life. The study found that mPVCR is a safe and effective surgical option that can significantly improve kyphosis angle, sagittal vertical axis, and patient-reported outcomes.

Study Duration
2 years
Participants
22 adults with severe post-tubercular kyphosis
Evidence Level
Not specified

Key Findings

  • 1
    The modified PVCR technique resulted in a significant improvement in kyphosis angle (KA) from 129.5° to 43.7° postoperatively.
  • 2
    There was a significant improvement in sagittal vertical axis (SVA) after surgery, decreasing from 30.9 mm preoperatively to 15.0 mm postoperatively.
  • 3
    Patients showed significant improvements in neurological function, Oswestry Disability Index (ODI) scores, and Scoliosis Research Society-22 (SRS-22) scores after the surgery.

Research Summary

This study retrospectively analyzed 22 patients with severe post-tubercular kyphosis (PTK) who underwent modified posterior vertebral column resection (mPVCR). The results demonstrated significant improvements in radiographic parameters (KA and SVA) and functional outcomes (ASIA grades, ODI, and SRS-22 scores). The authors conclude that mPVCR is a safe and effective surgical option for patients with extremely severe PTK requiring aggressive correction.

Practical Implications

Surgical Technique

mPVCR can be considered a viable surgical option for adults with severe PTK, particularly when aggressive correction is needed.

Reduced Complications

The delayed resection of posterior elements in mPVCR may contribute to reducing intraoperative blood loss and iatrogenic spinal cord injury.

Patient Outcomes

Appropriate correction, while avoiding overcorrection, can lead to improved neurological outcomes and overall quality of life for patients with severe PTK.

Study Limitations

  • 1
    Retrospective study design
  • 2
    Limited sample size
  • 3
    Lack of a control group

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