Vertebral column resection with anterior column reconstruction through posterior only approach for thoracolumbar spine

Abbassy, Mahmoud; Deif, Osama Ahmed; Agamy, Mohammed Mostafa; Khalil, Ahmed Mohamed

doi:10.21608/pajn.2025.311898.1144

Vertebral column resection with anterior column reconstruction through posterior only approach for thoracolumbar spine

Document Type : Original Articles

Authors

¹ Alexandria University

² neurosurgery department, alexandria university, alexandria, egypt

³ Alexandria university, faculty of medicine

⁴ neurosurgery department,faculty of medicine,alexandria university

10.21608/pajn.2025.311898.1144

Abstract

Background: Thoracolumbar vertebral distortion due to either trauma or neoplastic and inflammatory lesions represent a common cause of spinal deformity and neurological deficit, in these cases vertebral column resection (VCR) and anterior column reconstruction is used in maintaining spinal integrity and preventing progressive kyphosis and instrumentation failure
Aim: Evaluation of the outcome posterior only approach for VCR and anterior column reconstruction.
Methods: Thirteen patients were presented with distorted thoracolumbar vertebra due to either trauma, infection or neoplastic lesion; all patient were operated through posterior only approach with local resection via a bilateral transpedicular route with reconstruction of the anterior column using mesh cage or methylmethacrylate combined with posterior transpedicular screw fixation. Visual analogue scale(VAS), American spinal injury association(ASIA) score for neurological status and Cobb angle were used to determine the preoperative condition and the postoperative outcome.

Results: Eight males and 5 females with a mean age 48.6 years (28 – 64). Nine patients had single level VCR, 4 patients had double level. All patients had severe back pain, 10 cases had neurological deficit and 7 cases had local kyphosis. VAS score diminished to a mean of 2.8 from 8.5 preoperatively, 8 cases out of 10 cases had improved neurological status and Kyphotic angle decreased to 31.8±10.9° in cases presented with kyphosis.

Conclusion: This technique is safe and effective in achieving the goal of maintaining spinal alignment and preventing neurological deterioration

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