Posterior Hemivertebra Resection with Bisegmental Fusion for Congenital Scoliosis: More Than 3 Year Outcomes and Analysis of Unanticipated Surgeries

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2012 Nov 27

PMID 23179979

Citations 22

Authors

Shengru Wang

Jianguo Zhang

Guixing Qiu

Shugang Li

Bin Yu

Xisheng Weng

Affiliations

Soon will be listed here.

Abstract

Purpose: Until now there have been many reports on hemivertebra resection. But there were no large series on the posterior hemivertebra resection with bisegmental fusion. This is a retrospective study to evaluate the surgical outcomes of posterior hemivertebra resection only with bisegmental fusion for congenital scoliosis caused by fully segmented non-incarcerated hemivertebra.

Methods: In our study, 36 consecutive cases (19 males, 17 females) diagnosed with congenital scoliosis, resulting from fully segmented non-incarcerated hemivertebra, treated by posterior hemivertebra resection with bisegmental fusion were investigated retrospectively, with at least a 3 year follow-up period (36-106 months).

Results: The total number of resected hemivertebra was 36. Mean operation time was 188.6 min with average blood loss of 364.2 ml. The segmental scoliosis was corrected from 36.6° to 5.1° with a correction rate of 86.1 %, and segmental kyphosis(difference to normal segmental alignment) from 21.2° to 5.8° at the latest follow-up. The correction rate of the compensatory cranial and caudal curve is 76.4 and 75.1 %. Unanticipated surgeries were performed on eight patients, including one delayed wound healing, two pedicle fractures, one progressive deformity and four implants removals.

Conclusions: Posterior hemivertebra resection with bisegmental fusion allows for early intervention in very young children. Excellent correction can be obtained while the growth potential of the unaffected spine could be preserved well. However, it is not indicated for the hemivertebra between L5 and S1. The most common complication of this procedure is implant failure. Furthermore, in the very young children we noted that although solid fusion could be observed in the fusion level, implants migration may still happen during the time of adolescence, when the height of the body developed rapidly. So a close follow-up is necessary.

Citing Articles

Presence of compensatory curve predicts postoperative curve progression in congenital scoliosis after thoracolumbar hemivertebra resection and short fusion.

Xu Y, Li J, Li D, Li P, Kiram A, Xu H Eur Spine J. 2024; 33(12):4457-4466.

PMID: 39007983 DOI: 10.1007/s00586-024-08398-0.

Posterior concave reconstruction with cage in the surgical treatment of complex lumbar deformity caused by lumbosacral hemivertebrae.

Li Q, Hu B, Yang H, Feng G, Liu L, Yang X Eur Spine J. 2023; 33(5):2079-2087.

PMID: 37955750 DOI: 10.1007/s00586-023-08012-9.

Posterior hemivertebra resection without internal fixation in the treatment of congenital scoliosis in very young children.

Xia B, Wang H, Dong Y, Liu F, Wang W, Hu W Front Surg. 2023; 9:1018061.

PMID: 36684159 PMC: 9852748. DOI: 10.3389/fsurg.2022.1018061.

Hemivertebra Resection in Small Children. A Literature Review.

Frank S, Piantoni L, Tello C, Remondino R, Galaretto E, Falconi B Global Spine J. 2022; 13(3):897-909.

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Molecular identification of T-box transcription factor 6 and prognostic assessment in patients with congenital scoliosis: A single-center study.

Zhang W, Yao Z, Guo R, Li H, Zhao S, Li W Front Med (Lausanne). 2022; 9:941468.

PMID: 36035411 PMC: 9403053. DOI: 10.3389/fmed.2022.941468.

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