A modified surgical procedure for congenital kyphoscoliosis: selective partial hemivertebrectomy via posterior-only approach

Ge, Chao; Huang, Jia; Zeng, Kefeng; Guo, Qiang; Zhang, Hongqi

doi:10.1007/s00381-015-2630-9

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…Incarcerated hemivertebra and a balanced trunk usually have a benign result, while non-incarcerated hemivertebra has a normal-growth plate leading to progression of a wedge-shaped deformity. Scoliosis caused by non-incarcerated hemivertebra is more rigid than other types, which is difficult to correct by conservative treatment such as back brace and cast, which often requires surgery for correction [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Posterior hemivertebra resection with unilateral instrumented fusion in children less than 10 years old: preliminary results at minimum 5-year follow-up

Xue

Zhao

2018

J Orthop Surg Res

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BackgroundThe main treatment for congenital hemivertebra is posterior hemivertebrectomy with bilateral transpedicular fixation. To date, studies describing posterior unilateral fusion are few, especially in younger children. The modified method by posterior hemivertebrectomy combined with unilateral transpedicular instrumentation and fusion was described. The purpose was to present the clinical and radiological outcome of children less than 10 years treated for congenital scoliosis with posterior hemivertebrectomy and unilateral instrumented fusion.MethodsA study of 43 consecutive patients through Jan. 2006 to Mar. 2013 for hemivertebrae in children less than 10 years was performed. Patients undergoing hemivertebrectomy and posterior convex short-segment fusion, which had been followed up for at least 60 months, were included. Coronal main curve, kyphosis, T1-S1 height, fused vertebra height, and concave height were measured at preoperation, immediate postoperation, and final follow-up. The outcome and efficacy of the correction provided and growth of the non-fused concave side of the spine was investigated.ResultsThe average follow-up period was 73.88 ± 16.77 months. The mean Cobb angle of the coronal curve was improved from 46.1 to 8.1° (correction rate 82.4%). At final follow-up, there was 7.8% loss of correction. The average concave height, fusion segment height, and T1-S1 height were 60.1 ± 19.7 mm, 56.9 ± 22.9 mm, and 326.6 ± 64.5 mm in immediate postoperation, which improved to 73.1 ± 23.7 mm, 71.2 ± 22.0 mm, and 388.7 ± 78.9 mm at the last follow-up. These parameters were significantly different between the immediate postoperation and at final follow-up. The rate of reoperation was 9.3% (4/43), mainly in PJK and curve progression after surgery.ConclusionsDespite with some complications, posterior hemivertebrectomy and unilateral instrumented fusion are commendable procedures. We concluded that it is a simple, secure, reliable, less-invasive, and well-tolerated technique that can successfully resolve this kind of congenital scoliosis in children.

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Section: Introductionmentioning

confidence: 99%

Posterior hemivertebra resection with unilateral instrumented fusion in children less than 10 years old: preliminary results at minimum 5-year follow-up

Xue

Zhao

2018

J Orthop Surg Res

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“…The delayed treatment of adolescence congenial deformity result in the secondary structural curves and therefore requires long fusion segments. In other word, it is di culty to correct the rigid curves and associated with a higher risk of neurologic impairment [15].…”

Section: Discussionmentioning

confidence: 99%

Hemivertebra Resection Combined With Wedge Osteotomy for Treatment of Severe Rigid Congenital Kyphoscoliosis in Adolescence

Yin

Yan

He³

et al. 2020

Preprint

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Background There was a controversy about surgery approach of severe rigid congenital kyphoscoliosis in adolescence treatment. Aim of the study is to compare the clinical efficacy of surgical treatement by hemivertebra resection (HR) and hemivertebra resection combined with wedge osteotomy (HRWO) for severe rigid congenital kyphoscoliosis in adolescence. Methods Twenty-five patients with severe rigid congenital kyphoscoliosis between Jan 2006 and Dec 2011 were studied in our center. The patients were divided into hemivertebra resection group (group HR) or hemivertebra resection combined with wedge osteotomy group (group HRWO). The clinical and radiographic evaluation in terms of operation time, blood loss, correction rate, fusion time, hospital stay, complications and SRS-24 questionnaire score were compared between Group A and Group B. Results It is obvious that group HR achieved much better results in time of operation time, intra-operative blood loss, and hospital stay than group HRWO (P < 0.05). But meanwhile, group HRWO was significantly better than group HR in the times of coronal Cobb angle, kyphosis, the sagittal imbalance, coronal imbalance and SRS-24 questionnaire score (P < 0.05). There were no significant differences between the two groups in the age, mean flexibility, follow-up time, fusion time, and complications in the last follow-up (P > 0.05). Conclusion The outcomes of follow-up showed that the hemivertebra resection combined with wedge osteotomy approach obtained better clinical outcomes hemivertebra resection surgery. It might be a better surgical treatment for severe rigid congenital kyphoscoliosis in adolescence patients, but it needs longer operation time, more intra-operative blood loss, and extended hospital stay.

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“…существуют также исследования, в которых пока-зана эффективность селективной частичной геми-вертебротомии из зад него доступа при коррекции врожденного кифосколиоза на фоне полупозвон-ка у детей старшего возраста (9-14 лет). g. chu с соавторами считают, что такая методика может сбалансировать рост позвоночника с двух сторон и обеспечить достижение удовлетворительного терапевтического эффекта посредством устране-ния избыточного цент ра роста [19].…”

Section: таблица 1/unclassified

Surgical Treatment of Children With Congenital Lumbar Scoliosis: Complete or Partial Resection of Malformed Vertebrae?

Vissarionov¹,

Картавенко²,

Kokushin³

et al. 2017

Traumatology and Orthopedics of Russia

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The purpose of the study – to compare the effectiveness of surgical correction of spine lumbar congenital deformity by complete or partial resection of the abnormal vertebra in children.Material and methods. 68 children with isolated congenital malformation of the lumbar area of the spine were evaluated both clinically and instrumentally. Age of the patients was 6 months — 16 years 2 months (mean — 4 years 5 months). There were 41 female and 27 male patients. Patients were divided in two groups depending on the volume of the surgery. First group (n = 52) consisted of patients treated with complete hemivertebrae resection. Second group (n = 16) consisted of patients treated with partial resection of the malformed vertebrae.Results. After the surgery in the 1st group scoliotic curve was 0 to 21° and kyphotic curve was from -33 to 9°. 9 years post-op scoliotic and kyphotic curves were 0 to 22° and -31 to 10° respectively. In the 2nd group scoliotic curve was 3 to 27° and kyphotic curve was from -30 to 12°. 9 years post-op scoliotic and kyphotic curves were 7 to 41° and -26 to 8° respectively. Significant differences in the amount of scoliotic curve correction were revealed between the groups: in the 1st group mean Cobb angle for the scoliotic curve after surgery was 3,3° (correction — 94%), in the 2nd group — 13,6° (correction — 80%) (p0,05). Mean Cobb angle for the scoliotic curve in the long-term period was 5° (correction — 92%) for the 1st group wich was significantly lower (p0,05) comparing to the 2nd group (mean Cobb angle 18,3° correction — 62%).Conclusion. Our data showed higher efficacy of the complete resection of the hemivertebrae comparing to its partial resection in pediatric patients with isolated malformation in the lumbar spine. Complete removal of the vertebrae body, its growth plates and disks allowed to achieve radical correction of the deformity and to perform short fusion of the adjacent segments which was crucial for further normal growth and development of the child’s spine with saving the results in the long-term period. Thus complete resection of the malformed vertebrae with radical correction and short segment fusion is the most appropriate option in surgical treatment of pediatric patient of any age with isolated vertebrae malformation in the lumbar spine.

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A modified surgical procedure for congenital kyphoscoliosis: selective partial hemivertebrectomy via posterior-only approach

Cited by 7 publications

References 19 publications

Posterior hemivertebra resection with unilateral instrumented fusion in children less than 10 years old: preliminary results at minimum 5-year follow-up

Posterior hemivertebra resection with unilateral instrumented fusion in children less than 10 years old: preliminary results at minimum 5-year follow-up

Hemivertebra Resection Combined With Wedge Osteotomy for Treatment of Severe Rigid Congenital Kyphoscoliosis in Adolescence

Surgical Treatment of Children With Congenital Lumbar Scoliosis: Complete or Partial Resection of Malformed Vertebrae?

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