Modified posterior vertebral column resection for extremely severe post-tubercular kyphosis in adults: a two-year follow-up

Objective To describe the clinical and radiographic outcomes of patients with severe post-tubercular kyphosis (PTK) in adults who underwent modified posterior vertebral column resection (mPVCR). Methods A retrospective analysis was conducted on data from 22 patients with severe PTK who underwent surgical treatment. All patients received a one-stage mPVCR deformity correction. General information, radiological parameters including kyphosis angle (KA) and sagittal vertical axis (SVA), functional outcomes including America Spinal Injury Association (ASIA) grades, Oswestry Disability Index (ODI), Scoliosis Research Society-22 (SRS-22) scores, and complications were recorded. Results The mean age of the population was 33.6 ± 11.6 years (range: 18-59 years). The average operation time was 383.2 ± 53.8 min, and the mean intraoperative blood loss was 1652.3 ± 331.8 ml. Significant changes in KA (preoperative: 129.5 ± 17.3° vs. postoperative: 43.7 ± 7.6°; p Conclusion Modified PVCR represents a safe surgical option for patients with extremely severe PTK requiring aggressive correction. Delayed resection of the posterior elements may contribute to reducing intraoperative blood loss and iatrogenic spinal cord injury during osteotomy. Appropriate correction, while avoiding overcorrection, is beneficial for decreasing neurologic complications.