A vertebral column resection or VCR is a kind of osteotomy that is performed for correction of severe spinal deformity. Osteotomy is removal of bone, but in the case of VCR, it is one step further, where the doctor removes or resects one or multiple vertebrae from your spine.

In the case of mild osteotomy, such as posterior column osteotomy and pedicle subtraction osteotomy, it is not required to remove any vertebrae. Rather, in these processes, resection of small bone sections on the back part of the spine is carried out. But when you have more than 100 degrees of curvature or kyphosis, then removal of a small section of the bone does not work. So, you will require a VCR for fixing your spinal alignment.

Vertebral column resection is a latest and complicated spinal surgery that is performed to address severe deformities in the spinal structure, such as scoliosis, spinal tumors and kyphosis. VCR procedure not only helps in achieving spinal realignment but also stabilizes and decompresses the neural structures.

How is vertebral column resection done?

In vertebral column resection, the spine surgeon first positions the patient in a face-down position on a Jackson frame. This is a table that consists of a gentle slope for exposing the back side of your spine.

Based on the situation, your surgeon will assess your back either through posterior or anterior approach. In some cases, a doctor attains the best result by making use of a combined approach. Next, the surgeon fastens the pedicle screws to the vertebrae, thus attaching the vertebrae above and below the resection area. After this, the back part of the target vertebrae is removed by the surgeon:

• The three bony points present on the vertebrae’s back side
• The bony shell guarding the spinal cord
• The join where the two vertebrae comes together
• The bone swatch that links the vertebral body to the process

After removing these parts, the surgeon can now view the spinal cord along with the round front part of the vertebra, called the vertebral body. Upon removal of the left side of the vertebral body, the surgeon adds rods to every screw. This is an important step in this surgical process as it gives protection to the weak spinal cord.

The next step is excision of the affected vertebrae. In case more than one resection is required, your surgeon repeats the same steps for all. However, if the thoracic spine is the surgeon’s target, then he might remove the ribs to reach the target vertebrae.

After removal of the impacted vertebrae, there will be a wedge-shaped gap in the spine’s back, which the surgeon then realigns and closes this gap.

Conclusion

Severe cases of spinal deformities can lead to substantial pain and problems in carrying out daily tasks and complications related to breathing. A vertebral column resection can help in restoration of the overall quality of life and proper spinal alignment.

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