ABSTRACT Objective To evaluate the surgical efficacy of repeated vertebral column resection (Re‐VCR) after instrumentation removal in congenital scoliosis (CS) patients previously undergoing primary posterior spinal correction with VCR, and to analyze complications pertinent to revision surgery. Methods In this retrospective cross‐sectional study, a total of 16 CS patients who underwent Re‐VCR following instrumentation removal between February 2013 and February 2022 were reviewed. Radiographic parameters were assessed pre‐ and post‐primary operation, pre‐removal, pre‐ and post‐revision and at the last follow‐up. Clinical data were also analyzed and recorded for each patient. Results The indications for instrumentation removal were infection, implant failure, patient and family request, and persistent pain. The Cobb angle of the main curve, global kyphosis (GK), coronal balance (CB) and sagittal vertical axis (SVA) significantly progressed after instrumentation removal. The average progression rates of scoliosis and kyphosis were 5.3° ± 4.0°/year and 10.0° ± 7.2°/year. Following revision surgery, the Cobb angle of the main curve, GK, CB showed significant improvement ( t = 10.694, p 0.05). Compared with pre‐revision, the mean scores of pain, satisfaction, mental health and self‐image on the Scoliosis Research Society‐22 (SRS‐22) questionnaire improved at different levels. Intra‐revision complications included alert of neurophysiological monitoring and dural tear, while breakage of the distal L5 pedicle screw occurred in 1 (6.3%) patient 2 years after revision. Conclusions Severe progression of deformity and trunk imbalance was frequently observed following instrumentation removal. The removal of instrumentation is not routinely recommended, and revision surgery employing Re‐VCR frequently necessitates an extension of the fusion level. Satisfactory radiographic and clinical outcomes following Re‐VCR were effectively maintained throughout the follow‐up period, but great caution should be exercised during Re‐VCR.
Li et al. (Thu,) studied this question.