BACKGROUND: Posterior vertebral column resection (PVCR) is a challenging but effective technique for the correction of complex @entity85 . However, it has a high complication rate and carries a substantial risk for @entity16 . PURPOSE: The aim was to test whether the apex of the deformity influences the clinical outcomes and complications in @entity1 undergoing PVCR. STUDY DESIGN: A historical cohort was recruited from a single center and evaluated preoperatively, postoperatively, and at final follow-up. @entity1 SAMPLE: Ninety-eight hyperkyphotic @entity1 undergoing PVCR were included. Inclusion criteria consisted of @entity3792 and hyperkyphosis surgically treated with PVCR as a primary or revision procedure. OUTCOME MEASURES: The outcome measures included a number of @entity16 . METHODS: Receiver operator characteristic (ROC) curve analysis and Youden index (J) were used to estimate the optimum cut-off to predict @entity16 for each potential risk factor. In three ROC analyses, we included separately body mass index (BMI), @entity1513 degree, and age as independent variables and @entity16 as the dependent variable. Logistic regression was used to estimate the odds ratios (ORs) and construct 95% confidence intervals (CIs). RESULTS: Among the 98 @entity1 , the etiologies were: post infectious (50), congenital (31), and others (17). The averages were: age 14  6.5 years, BMI 20  10 kg/m(2), American Society of Anesthesiologists 3  0.7, forced vital capacity 76  23%, fusion levels 10  3, estimated @entity190 1,319  720 mL, surgical time 375  101 minutes, and preoperative localized @entity1513 104  30  . Thirty-three @entity1 had abnormal preoperative neurologic status. Major complications occurred in 46 @entity1 (neurologic in 25). The apex of @entity1513 was proximal thoracic T1-T5 (five @entity1 ), thoracic (TH) T6-T9 (17 @entity1 ), thoracolumbar T10-L2 (55 @entity1 ), and lumbar L3-S1 (nine @entity1 ). The level of apex and BMI were independent risk factors for @entity16 : TH apex (OR: 101.30, 95% CI: 1.420-infinite; p=.037); BMI (OR: 1.92, 95% CI: 1.110-infinite; p=.026). CONCLUSIONS: Posterior vertebral column resection for severe @entity85 is technically demanding and carries a substantial risk. The apex is a variable that influences the occurrence of @entity16 , and the presence of a TH apex in particular could be a preoperative risk factor for @entity16 .

Apex of XXXX . Does it matter in the occurrence of complications?

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENT'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurologic complications', 'neurologic injury'] @entity1513 :: ('MESH:D007738', 'Disease') :: ['kyphosis'] @entity3792 :: ('MESH:C565711', 'Disease') :: ['kyphoscoliosis'] @entity85 :: ('MESH:D009140', 'Disease') :: ['spinal deformity', 'spine deformity']
@entity85 :: (MESH:D009140,Disease) :: ['deformity for three-column osteotomy']
