Posterior 360-degree total vertebra osteotomy for treatment of severe kyphoscoliosis

Objective To evaluate the efficacy and safety of 360-degree posterior total vertebral osteotomy for correction of severe kyphoscoliosis.Methods A retrospective study was conducted.From 1998 to 2005,thirty-one patients with severe kyphoscoliosis deformity were surgically treated with posterior total vertebral osteotomy and fusion.There were 14 males and 17 females with an average age of 16.7 years(9~37 years).The pre-operative kyphosis was 103°(90°~153°) and scoliosis was 95°(76°~159°).There were 5 patients with neurological symptoms before operation.All patients underwent posterior total vertebral osteotomy at the apical vertebra,trans-pedicular fixation,correction and fusion.Results All patients underwent surgery safely and there was no major complication of neurological injury and hardware failure.The average surgery time was 4.6 hours and blood loss of 1170 ml in average(920~2300 ml).There was no but two with superficial skin infection.The post-operative average kyphotic and scoliotic curves were 53.3°(39°~86°) and 51.2°(11°~79°),respectively.The correction rates for kyphosis and scoliosis were 53.3% and 63.7%,respectively.The neurological function of five patients with neurological symptoms pre-operatively had improved after operation.All the patients were followed up for at least 1 year(1~5.2 years).There was one patient developed pseudarthrosis and revision was performed 9 months post-operatively and solid fusion was achieved afterwards.At latest follow up evaluation,97% of the patients were satisfied with the results.Conclusions Posterior 360-degree vertebral osteotomy is an effective and safe surgical technique for correcting severe and rigid kyphoscoliosis.