Outcome of Posterior Vertebral Column Resection (PVCR) and Reconstruction Due to Post Tubercular Kyphoscoliotic Deformity

Abstract

Background: Post-tubercular kyphoscoliotic deformities are a significant complication of spinal tuberculosis, leading to severe functional impairment and neurological deficits. Posterior Vertebral Column Resection (PVCR) and reconstruction offer a surgical solution to manage such complex deformities, aiming to restore spinal alignment and function. Methods: The study included 15 consecutive patients with severe post-tubercular kyphoscoliotic deformities underwent Posterior vertebral column resection followed by spinal reconstruction between March, 2022 to September, 2024 and all the patient were followed up upto one year. During the operation, the average age was 39.2 years, with a range of 10 to 64 years. Preoperative and postoperative assessments included radiographic measures of deformity correction (kyphotic angle, Cobb angle), neurological function, and clinical outcomes by visual analogue score (VAS), Oswestry Disabilty index (ODI), and Modified Macnab’s criteria. Complications were documented and analyzed. Results: Posterior vertebral column resection resulted in significant correction of kyphosis and scoliosis, with a marked improvement in spinal alignment. Neurological function showed substantial recovery in most patients. The average blood loss amounted to 2476 millilitres, and the average duration of a posterior vertebral column resection surgery was 273.33 minutes. In cases of scoliosis and kyphosis, the average correction achieved through posterior vertebral column resection was 11.6° and 14.13°, respectively, leading to correction rates of 60.53% and 38.29%. Posterior vertebral column resection complications occurred in 20% of cases overall. Neurological issues were the most common, estimated at 13.3%. There were 6.67% patients suffered from early post-operative wound infection. Conclusion: Posterior Vertebral Column Resection (PVCR) combined with spinal reconstruction is an effective and reliable surgical technique for correcting post-tubercular kyphoscoliotic deformities. It provides significant deformity correction, functional recovery, and low complication rates, offering a promising solution for patients with severe, deformity-associated disability. Further studies with larger sample sizes and long-term follow-up are warranted to confirm these findings.

Bangladesh Armed Forces Med J Vol 58 No (1) June 2025, pp 30-38