Vertebral Column Resection
Severe rigid spinal deformity is a difficult problem for the spinal surgeon (Fig. 1). The traditional approach to severe rigid spinal deformities has included a stabilizing posterior spinal fusion with instrumentation, or an anterior release and fusion followed by a posterior spinal fusion with segmental instrumentation. Both of these approaches have resulted in variable, but mostly limited, correction, as a true translation of the spinal column is limited by these approaches. Vertebral column resection (VCR) is the only means of achieving significant vertebral column translation in these difficult deformities. It has traditionally been most commonly utilized for congenital scoliosis.
Vertebral column resection implies complete resection of the posterior elements, pedicles, and the entire vertebral body. It can be achieved through either an anterior-posterior approach (on a single day or staged), or through a posterior only approach. Generally, VCR does not result in direct bone-on-bone contact, as is common with Smith-Petersen and pedicle subtraction osteotomies; therefore, reconstruction of the anterior and posterior columns is required. As well, the procedure is considered a vertebral column