Objective      To evaluate the clinical efficacy and safety of one stage posterior total vertebral column resection in treatment of severe kyphoscoliosis. Methods      Thirty patients with severe kyphoscoliosis deformity (19 males and 11 females

at an average age of 33.8

ranging from 9 to 63) admitted in our department from January 2009 to December 2014 were subjected in this study. They were surgically treated with one stage posterior total vertebral column resection and fusion. There were 15 cases of deformity on thoracic segments

9 cases on lumbar segments and 6 cases on thoracolumbar segments. Of them

12 with idiopathic deformity

14 with congenital deformity

1 with old vertebral fracture

1 with spinal tuberculosis

2 with scoliosis revision surgery. The preoperative scoliosis Cobb angle was 96.2° (81°～149°)

kyphosis Cobb angle was 99.6° (86°～153°)

and apical offset 1.9～7.6 cm (mean 2.8 cm). According to Frankel grading system

3 patients were classified as grade D

and the others were grade E. Eight cases had mild respiratory dysfunction

and 22 cases had obvious chest pain. All patients underwent one stage posterior vertebral column resection

evaluation of nerve function and the improved Cobb angle after operation.  Results     The operation went smoothly

with an average surgery time of 4.6(3.5～6.0) h and average bleeding volume of 1 260(910～2 600) mL. The post-operative scoliosis Cobb angle was 44.3° (33°～68°

in a correction rate of 53.9%) and kyphosis Cobb angle was 43.5°(35°～79°

in a correction rate of 56%). The average apical offset was 0.7(0.2～2.3) cm

and the correction rate was 75%. The average height growth was 8.3 cm. There were 2 cases of Frankel grade recovery from D to E

and 1 case changed from D to B achieved

but recovered to E at the final follow-up. Cerebrospinal fluid leakage was observed in 1 case during the perioperative period

and the patient was cured after lumbar cistern drainage. No internal fixation loosening

fracture or other complications was seen in all the patients during the follow-up of more than 1 year. At the latest follow-up

92% of the patients were satisfied with the outcome. Chest pain was relieved in 22 patients

and the pain was disappeared completely in 18 of them 3 months later.   Conclusion      One stage posterior total vertebral column resection is an effective and safe surgical approach for severe kyphoscoliosis. But it requires highly technical skills

so cautious usage is necessary for satisfactory clinical efficacy.