Improvement of Life After PVCR in Complete Paraplegic Patients with Posttraumatic Severe Kyphosis

Abstract

AIM: To determine the effect of posterior vertebral column resection (PVCR) in patients with paraplegia by using the American Spinal Injury Association (ASIA) score and Scoliosis Research Society (SRS)-22 questionnaire. MATERIAL and METHODS: Twelve patients with posttraumatic paraplegia and severe angular kyphosis (>60 degrees) had undergone PVCR between 6-24 months after the trauma for severe pain, persistent vertebral instability and difficulty in adherence to rehabilitation. ASIA scores and SRS-22 questionnaire results obtained in the preoperative and postoperative periods, and the last control were statistically compared to assess the presence of any change. RESULTS: The average age of twelve patients included in this study was 35.6 +/- 10.2 (21-51) years. Female/male ratio was 2/10 (20.0%). The mean follow-up duration was 50.3 +/- 17.6 (24-86) months. None of the patients had additional changes in neuromonitoring records during surgery. The mean preoperative kyphotic angle of the patients was 66.58 degrees +/- 7.1 degrees (60 degrees-82 degrees) which decreased to 7.0 degrees +/- 5.4 degrees in the postoperative period (p<0.05). The mean ASIA score, which was 43.3 +/- 5.1 preoperatively, increased to 44.4 +/- 4.4 in the postoperative period. The SRS-22 score, which was 2.4 +/- 0.3 in the preoperative period, increased to 4.2 +/- 0.4 in the early postoperative period. This increase was found to be statistically significant (p<0.05). The SRS-22 score was 4.1 +/- 0.4 at last follow-up and was not statistically different from the early postoperative value (p>0.05). CONCLUSION: In the light of these data, it can be stated that PVCR is a safe and reliable procedure in paraplegic patients with rigid posttraumatic kyphosis and increases patient satisfaction.