| Summary: | Abstract Background Spinal deformity is a complex condition that can lead to global imbalance, neurologic deficits, and chronic back pain. Posterior vertebral column resection (PVCR) is one of the most powerful osteotomies for correcting severe deformities, but it is associated with significant complications. To address this, we explored a modified unilateral approach to PVCR to minimize surgical risks and preserve posterior spinal elements. Methods Eight patients with spinal deformities and neurological deficits underwent unilateral PVCR between 2021 and 2023. The technique involved preservation of the spinous process and posterior elements on one side. Postoperative neurological outcomes and complications were assessed. Results The mean age of patients was 48.25 years. All had preoperative neurological deficits, including urinary disturbances. No cases of dural injury, wound infection, or wound dehiscence were observed. Postoperatively, all patients showed either improvement or stabilization in neurological function. Conclusion This modified unilateral PVCR technique appears to be a safe and effective alternative to conventional bilateral PVCR. It allows preservation of posterior spinal structures, potentially reducing operative complications while achieving satisfactory deformity correction.
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