Repeated Vertebral Column Resection (Re‐ VCR ) in Congenital Scoliosis With Curve Progression After Instrumentation Removal

作者：Yinkun Li, Wanyou Liu, Benlong Shi, Zhen Liu, Saihu Mao, Jun Qiao, Zezhang Zhu, Yong Qiu · 发表于：Orthopaedic Surgery · 年份：2025 · DOI：10.1111/os.70198 · 被引用次数：2 · 研究领域：Scoliosis diagnosis and treatment、Spinal Fractures and Fixation Techniques、Spine and Intervertebral Disc Pathology

OBJECTIVE: To evaluate the surgical efficacy of repeated vertebral column resection (Re-VCR) after instrumentation removal in congenital scoliosis (CS) patients previously undergoing primary posterior spinal correction with VCR, and to analyze complications pertinent to revision surgery. METHODS: In this retrospective cross-sectional study, a total of 16 CS patients who underwent Re-VCR following instrumentation removal between February 2013 and February 2022 were reviewed. Radiographic parameters were assessed pre- and post-primary operation, pre-removal, pre- and post-revision and at the last follow-up. Clinical data were also analyzed and recorded for each patient. RESULTS: The indications for instrumentation removal were infection, implant failure, patient and family request, and persistent pain. The Cobb angle of the main curve, global kyphosis (GK), coronal balance (CB) and sagittal vertical axis (SVA) significantly progressed after instrumentation removal. The average progression rates of scoliosis and kyphosis were 5.3° ± 4.0°/year and 10.0° ± 7.2°/year. Following revision surgery, the Cobb angle of the main curve, GK, CB showed significant improvement (t = 10.694, p < 0.001; Z = -3.516, p < 0.001; Z = -2.664, p = 0.008). For Re-VCR, the average extension of the fusion level was 2.9 ± 1.4 vertebrae proximally, 3.0 (2.0, 3.0) vertebrae distally and 5.4 ± 1.6 vertebrae in total. The average correction rates of the Cobb angle of the main curve and GK were 59.5% ± 23.4% a...