Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus
In the past decades, an increasing number of surgeons started using posterior vertebral column resection (PVCR) to treat severe, rigid and angular spinal deformities. Little high-level evidence is available to guide surgical treatment. The aims of our study were to identify important surgical strate...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2017-07-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/2309499017713939 |
| _version_ | 1831569216463962112 |
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| author | Jing-Ming Xie Zhong-Qiang Chen Jian-Xiong Shen Xue-Song Zhang Cao Yang Zhao-Min Zheng Bang-Ping Qian Shiau-Tzu Tzeng Hui-Zhong Tian Chao Li Ji Wu Zeng-Hui Wu Wen-Yuan Ding Yuan Ma Shi-Xin Du Yu-Shu Bai Ying-Song Wang Li-Min Liu Hua Yang Zhuo-Jia Zhou Shi-Ming Xie Qi Cao Zhao Yang |
| author_facet | Jing-Ming Xie Zhong-Qiang Chen Jian-Xiong Shen Xue-Song Zhang Cao Yang Zhao-Min Zheng Bang-Ping Qian Shiau-Tzu Tzeng Hui-Zhong Tian Chao Li Ji Wu Zeng-Hui Wu Wen-Yuan Ding Yuan Ma Shi-Xin Du Yu-Shu Bai Ying-Song Wang Li-Min Liu Hua Yang Zhuo-Jia Zhou Shi-Ming Xie Qi Cao Zhao Yang |
| author_sort | Jing-Ming Xie |
| collection | DOAJ |
| description | In the past decades, an increasing number of surgeons started using posterior vertebral column resection (PVCR) to treat severe, rigid and angular spinal deformities. Little high-level evidence is available to guide surgical treatment. The aims of our study were to identify important surgical strategies and key technical points of Chinese experts who have extensive experience in the management of severe, rigid and angular spinal deformities using PVCR, and to standardize and unify the current core concepts. Workgroups of consensus were formed by selecting nationwide representing experts and comprehensive consultations. Eight task forces for major issues were established, then retrieval of literature, collection of expert opinions and writing of review articles were carried out. A modified Delphi process was chosen in round-table forum with three face-to-face meetings. Consensus was reached with items graded more than seven points including: indications and contraindications of PVCR; review PVCR in the evolution of spinal osteotomies; The corrective mechanism and safety of spinal cord; monitoring and responses of spinal cord crisis; characteristics and therapeutic outcome of pulmonary function; management of bleeding during PVCR; relationship of pedicle screw insertion and spinal cord safety; and analysis of non-neurologic complications and prevention strategies. In conclusion, The essential properties regarding PVCR procedure are tightly linked with various factors such as medical and surgical indication, range and level of vertebral column resection, strategies of correction, corrective efficiency and control of neurological risk. PVCR is used mainly for severe, rigid spinal deformity that is not manageable by other osteotomy techniques. |
| first_indexed | 2024-12-17T12:29:44Z |
| format | Article |
| id | doaj.art-3ccb0ca9c24f4a48abf0d65f91e5306e |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-17T12:29:44Z |
| publishDate | 2017-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-3ccb0ca9c24f4a48abf0d65f91e5306e2022-12-21T21:48:37ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902017-07-012510.1177/2309499017713939Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensusJing-Ming Xie0Zhong-Qiang Chen1Jian-Xiong Shen2Xue-Song Zhang3Cao Yang4Zhao-Min Zheng5Bang-Ping Qian6Shiau-Tzu Tzeng7Hui-Zhong Tian8Chao Li9Ji Wu10Zeng-Hui Wu11Wen-Yuan Ding12Yuan Ma13Shi-Xin Du14Yu-Shu Bai15Ying-Song Wang16Li-Min Liu17Hua Yang18Zhuo-Jia Zhou19Shi-Ming Xie20Qi Cao21Zhao Yang22 Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China Department of Orthopaedics, Peking University International Hospital, Beijing, China Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China Department of Orthopaedic Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan Shi, Hubei, China Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China Department of Spine Surgery, Drum Tower Hospital, Medical School of Nanjing University, Jiangsu, China Department of Orthopaedics, Buddhist Tzu Chi General Hospital-Taipei Branch, Tzu Chi University, Hualien, Taiwan Research Institution of Spinal Surgery, Six Affiliated Hospital of Xinjiang Medical University, Xinjiang Weiwuerzizhiqu, China Department of Orthopaedics, Fuyang People’s Hospital, Anhui, China Department of Orthopaedics, Air Force General Hospital of PLA, Beijing, China Hospital of Orthopaedic Surgery, Guangzhou Military General Hospital, Guangdong, China Department of Spine, Third Hospital of Hebei Medical University, Hebei, China Research Institution of Spinal Surgery, Six Affiliated Hospital of Xinjiang Medical University, Xinjiang Weiwuerzizhiqu, China Department of Orthopaedics, Luohu People’s Hospital, Shenzhen, China Department of Orthopaedics, Changhai Hospital, The Second Military Medical University, Yangpu Qu, Shanghai, China Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China Department of Orthopaedics, West China Hospital, Sichuan University, Sichuan, China Department of Spine Surgery, The Affiliated Hospital of Guiyang Medical College, Guizhou, China Department of Orthopaedic, Guizhou Provincial People’s Hospital, Guizhou, China Department of Spine, Mianyang Orthopedic Hospital, Sichuan, China Department of Spinal Surgery, The Second Affiliated Hospital of the Nanhua University, Chiayi, Hunan, China Department of Orthopaedics, First People’s Hospital of Yunnan Province, Yunnan, ChinaIn the past decades, an increasing number of surgeons started using posterior vertebral column resection (PVCR) to treat severe, rigid and angular spinal deformities. Little high-level evidence is available to guide surgical treatment. The aims of our study were to identify important surgical strategies and key technical points of Chinese experts who have extensive experience in the management of severe, rigid and angular spinal deformities using PVCR, and to standardize and unify the current core concepts. Workgroups of consensus were formed by selecting nationwide representing experts and comprehensive consultations. Eight task forces for major issues were established, then retrieval of literature, collection of expert opinions and writing of review articles were carried out. A modified Delphi process was chosen in round-table forum with three face-to-face meetings. Consensus was reached with items graded more than seven points including: indications and contraindications of PVCR; review PVCR in the evolution of spinal osteotomies; The corrective mechanism and safety of spinal cord; monitoring and responses of spinal cord crisis; characteristics and therapeutic outcome of pulmonary function; management of bleeding during PVCR; relationship of pedicle screw insertion and spinal cord safety; and analysis of non-neurologic complications and prevention strategies. In conclusion, The essential properties regarding PVCR procedure are tightly linked with various factors such as medical and surgical indication, range and level of vertebral column resection, strategies of correction, corrective efficiency and control of neurological risk. PVCR is used mainly for severe, rigid spinal deformity that is not manageable by other osteotomy techniques.https://doi.org/10.1177/2309499017713939 |
| spellingShingle | Jing-Ming Xie Zhong-Qiang Chen Jian-Xiong Shen Xue-Song Zhang Cao Yang Zhao-Min Zheng Bang-Ping Qian Shiau-Tzu Tzeng Hui-Zhong Tian Chao Li Ji Wu Zeng-Hui Wu Wen-Yuan Ding Yuan Ma Shi-Xin Du Yu-Shu Bai Ying-Song Wang Li-Min Liu Hua Yang Zhuo-Jia Zhou Shi-Ming Xie Qi Cao Zhao Yang Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus Journal of Orthopaedic Surgery |
| title | Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus |
| title_full | Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus |
| title_fullStr | Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus |
| title_full_unstemmed | Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus |
| title_short | Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus |
| title_sort | expert consensus for pvcr in severe rigid and angular spinal deformity treatment the kunming consensus |
| url | https://doi.org/10.1177/2309499017713939 |
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