{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:52:15Z","timestamp":1791388335278,"version":"4.3.3"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR) are powerful techniques for correcting severe spinal deformities. Although PSO has been proposed as a viable alternative to VCR, their comparative efficacies and safety profiles require further elucidation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This single-center retrospective study analyzed 169 patients (mean age, 22 years; 84 male; 169 ethnic Chinese) with severe kyphoscoliosis who underwent primary corrective surgery via PSO (n = 85) or VCR (n = 84). Radiographic parameters, surgical data, intraoperative neuromonitoring (IOM) changes, Scoliosis Research Society (SRS)-22 scores, and complications were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Both techniques significantly improved all radiographic parameters and SRS-22 scores (p &lt; 0.001). The VCR group demonstrated superior correction of the major curve (65.5% versus 56.9%, p = 0.003), segmental kyphosis (68.1% versus 61.5%, p = 0.03), and apical vertebral rotation (48.5% versus 34.4%, p = 0.001). At the critical osteotomy stage, 105 (62.1%) of 169 patients experienced IOM signal decline. The neurological complications rate was significantly higher in the VCR group (13 of 84 versus 7 of 85, p = 0.038), as was the overall complication rate (43 of 84 versus 29 of 85, p = 0.008). Each 1\u00b0 increase in correction achieved with VCR was associated with a 1.6% higher risk of complications (OR = 1.016, p = 0.045).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although both PSO and VCR were highly effective for major deformity correction, VCR provided a greater magnitude of correction in the coronal, sagittal, and axial planes. However, this advantage was counterbalanced by a significantly higher risk of complications, including neurological deficits. Despite the frequent reversibility of IOM signal declines, VCR retained a higher risk profile due to its higher overall complication rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.25.01393","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T18:00:23Z","timestamp":1776794423000},"page":"1558-1565","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["High-Grade 3-Column Osteotomies Are Not Interchangeable"],"prefix":"10.2106","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5925-9031","authenticated-orcid":false,"given":"Yiqiao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3264-7618","authenticated-orcid":false,"given":"Zhuosong","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0855-2702","authenticated-orcid":false,"given":"Yuechuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0084-2577","authenticated-orcid":false,"given":"Yunze","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5217-1932","authenticated-orcid":false,"given":"Qianyu","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3129-5190","authenticated-orcid":false,"given":"Jianguo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"issue":"Suppl 1","key":"bib1-20261007","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1227\/01.neu.0000462076.73701.09","article-title":"The comprehensive anatomical spinal osteotomy classification","volume":"76","author":"Schwab","year":"2015","journal-title":"Neurosurgery."},{"issue":"14","key":"bib2-20261007","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1097\/00007632-199707150-00013","article-title":"Vertebral column resection 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