{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:29:28Z","timestamp":1781612968947,"version":"3.54.5"},"reference-count":12,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Surgery for adolescent idiopathic deformities is often aimed at improving aesthetic appearance, striving for the best possible correction. However, severe and rigid scoliotic curves not only present aesthetic issues but can also compromise cardiopulmonary health and cause early neurological impairment due to spinal cord compression, posing significant risks of morbidity and mortality if untreated. Conservative treatments are ineffective for severe curves, defined by scoliotic angles over 70\u00b0 and flexibility below 30% on lateral bending X-rays. Treatment often requires invasive interventions, such as osteotomies and vertebral resections. In particular, posterior vertebral column resection (PVCR) has shown effectiveness in realigning vertebral structures in complex cases. This study describes the efficacy and risks of PVCR through a series of cases treated at our institution. Methods: This case series was conducted at the Rizzoli Orthopedic Institute in Bologna, involving eight pediatric patients with severe, rigid spinal deformities, operated upon between 2018 and 2023. The underlying pathologies included idiopathic kyphoscoliosis, neurofibromatosis type 1, Pott\u2019s disease, and other congenital anomalies. Preoperative assessment included standard radiographs, magnetic resonance imaging, and computed tomography. During PVCR, motor and sensory evoked potentials were monitored to minimize neurological injury risk. Postoperative management included blood transfusions, antibiotic support, and early physiotherapy. Results: PVCR resulted in an average reduction in the Cobb angle from 86.3\u00b0 preoperatively to 22.4\u00b0 postoperatively, with a mean correction of 64%. The mean duration of the procedures was 337.4 min. Three patients had an uneventful postoperative course, while five developed complications, including infections and temporary neurological deficits, which were successfully managed. One patient developed an epidural hemorrhage that required emergency surgery for hematoma evacuation, with partial recovery. This study demonstrates the potential of PVCR for correcting rigid spinal deformities, highlighting the importance of postoperative management to minimize the associated risks. Conclusions: Posterior vertebral resection techniques offer significant promise in the correction of pediatric spinal deformities. Although ours is a small case series, it can provide important data for such treatment. Long-term monitoring is needed to fully understand the impact of these procedures and to further refine surgical techniques.<\/jats:p>","DOI":"10.3390\/jcm14020374","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T07:00:47Z","timestamp":1736406047000},"page":"374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and Risks of Posterior Vertebral Column Resection in the Treatment of Severe Pediatric Spinal Deformities: A Case Series"],"prefix":"10.3390","volume":"14","author":[{"given":"Emanuela","family":"Asunis","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cini","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Martikos","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Vommaro","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5185-4482","authenticated-orcid":false,"given":"Gisberto","family":"Evangelisti","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8344-7534","authenticated-orcid":false,"given":"Cristiana","family":"Griffoni","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gasbarrini","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"714","DOI":"10.5435\/JAAOS-D-14-00037","article-title":"Natural History of Adolescent Idiopathic Scoliosis in Skeletally Mature Patients: A Critical Review","volume":"23","author":"Agabegi","year":"2015","journal-title":"J. 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Medicina, 60.","DOI":"10.3390\/medicina60060897"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.wneu.2017.01.118","article-title":"Posterior Only Vertebral Column Resection for the Treatment of Severe Spinal Deformities in Pediatric Patients: A Retrospective Case Series","volume":"101","author":"Schroeder","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E664","DOI":"10.1097\/BRS.0000000000002948","article-title":"Comparison of Single-Level Versus Multilevel Vertebral Column Resection Surgery for Pediatric Patients With Severe Spinal Deformities","volume":"44","author":"Hwang","year":"2019","journal-title":"Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1097\/BPB.0000000000000729","article-title":"Posterior vertebral column resection with short-segment fusion for patients with congenital kyphoscoliosis","volume":"29","author":"Matsumura","year":"2020","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1097\/BRS.0b013e3181b53cba","article-title":"Posterior vertebral column resection for severe pediatric deformity: Minimum two-year follow-up of thirty-five consecutive patients","volume":"34","author":"Lenke","year":"2009","journal-title":"Spine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100070","DOI":"10.1016\/j.jnrt.2023.100070","article-title":"Clinical neurorestorative treatment guidelines for neurological dysfunctions of sequels from vertebral and spinal cord lesions (CANR 2023 version)","volume":"11","author":"Guo","year":"2023","journal-title":"J. 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