Objective: To observe the clinical effect and incidence rate of instrumentation failures for posterior vertebral column resection combinated reconstruction technique with bone graft around titanium mesh for treatment of severel angular kyphosis. Methods: From February 2004 to May 2013, 13 patients with severe angular kyphosis were treated with posterior total spondylectomy and bone grafting around titanium mesh. There were 5 males and 8 females with an average age of 23.8 years(16-39 years old). Among them, 5 cases resulted from old tuberculosis and 8 cases were congenital deformity. Cobb angle of sagittal kyphosis was with an average age of 122.5 degrees(107 -150 degrees). All patients had scoliosis, and the Cobb angle ranged from 11 degrees to 128 degrees, with an average of 54.5 degrees. The sagittal vertebra（SVA） axis was 2.7cm (0.5~4.6cm) before operation. There were 2 cases of neurological impairment, all of which were grade D according to Frankel classification. Result: The average operation time was 7 hours (6.6-10.7 hours), the average bleeding was 2 700-5100 ml (3000 ml), and the average spinal cord shortening was 1.1-2.1 cm (1.9 cm). The fusion segments were11-15 segments, with an average of 12.9 knots. The sagittal Cobb angle was 20 to 43 degrees, with an average of 29.6 degrees, with a correction rate of 75.9%. The coronal Cobb angle after operation was 0 to 54 degrees, with an average of 12.5 degrees, and an average correction rate of 87.0%. The SVA was corrected from 2.7 cm (0.5-4.6 cm) preoperatively to 0.6 cm (0.5-1.5 cm) postoperatively, with an average correction rate of 74.9%. All the patients were followed from 25 to 106 months, with an average of 49.2 months. Neurological function recovered to Frankel E grade of 2 patients with neurological impairment before operation. Bone fusion and stabe reconstruction were achieved in all patients with osteotomy and bone grafting around titanium mesh. There was no loosening or breakage of internal fixation and no significant loss of correction. Conclusion: PVCR with bone grafting around titanium mesh for severe angular kyphosis can not only effectively prevent spinal cord shortening and improve the corrective force, but also achieve excellent bone fusion and spinal stability, which can effectively prevent internal fixation breakage.