Emerging S-shaped curves in congenital scoliosis after hemivertebra resection and short segmental fusion

Yang, Xi; Song, Yueming; Liu, Limin; Zhou, Chunguang; Zhou, Zhongjie; Wang, Lei; Wang, Liang

doi:10.1016/j.spinee.2016.06.006

Cited by 21 publications

(16 citation statements)

References 21 publications

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“…As posterior hemivertebra resection and short fusion became a more widely applied treatment in the correction of progressive congenital scoliosis, postoperative new deformity has been reported as one of the most common complications of this surgery. 14 Deformity progression has a huge impact on initial correction and may lead to revision surgery. Wang et al 15 reported that 18.9% of congenital scoliosis patient with posterior hemivertebra resection and short fusion (7 in a series of 37) developed more than 10° kyphosis above the top of the instrumentation in a mean 4 years 6-month follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Hemivertebra Resection and Spinal Arthrodesis by Single-Stage Posterior Approach in Congenital Scoliosis and Kyphoscoliosis: Results at 9.6 Years Mean Follow-up

et al. 2022

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Background: Congenital kyphoscoliosis due to hemivertebra is generally treated surgically because of high risk of curve progression and high risk of nervous system complications. Modern posterior access surgical techniques, including total hemivertebra resection, can completely correct deformity without additional anterior access surgeries. The purpose of this study was to evaluate midterm results of hemivertebra resection and spinal arthrodesis; the hypothesis was that it is a safe, effective, and reproducible procedure.Materials and Methods: From 2006 to 2019, hemivertebra resection and instrumented spinal arthrodesis with pedicle screws was performed on 82 patients with congenital vertebral deformities (62 scoliosis and 20 kyphoscoliosis) by posterior approach. Mean age at surgery was 8.6 years, and 22 patients were under 10 years of age. After stabilization patients have been braced for a period from 3 to 5 months.Results: Mean follow-up was 9.6 years (range 1.2-12.8 years); mean kyphosis curve after surgery was reduced to 20° Cobb; and mean scoliosis curve was reduced to 11° Cobb. We experienced no major complications (postsurgical infection, instrumentation failure, severe neurological impairment, severe blood loss) at latest follow-up .Conclusion: We strongly advocate one-time posterior hemivertebra resection and arthrodesis as the most suitable surgical procedure for congenital scoliosis due to hemivertebra. Posterior approach interventions with pedicle screws instrumentation are less invasive than combined anterior-posterior approach interventions. We think that posterior approach procedures can lead to excellent deformity correction in both frontal and sagittal views, optimal stability, and low risk of nervous injury.Clinical Relevance: Congenital scoliosis treatment is one of the most challeging conditions a spine surgeon has to face. We advocate that a one-stage posterior approach for hemivertebrectomy and fusion is a reliable, safe tachnique, whom excellent results remain stable at a mid/long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Hemivertebra Resection and Spinal Arthrodesis by Single-Stage Posterior Approach in Congenital Scoliosis and Kyphoscoliosis: Results at 9.6 Years Mean Follow-up

et al. 2022

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“…The management of such cases is influenced by the clinical impact of the hemivertebra on the spinal cord, the degree of scoliosis if present, the complexity of the associated malformations if present and diagnosed, and of course, the wish of the future parents. Usually, when scoliosis is present, the typical management is resection [ 26 , 27 , 28 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

First-Trimester Diagnosis of Supernumerary Hemivertebra

et al. 2022

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Hemivertebra is a common cause of congenital scoliosis and results from a lack of formation of one-half of the vertebral body. This condition is very rare and can present as solitary or as a syndrome component: i.e., the split notochord syndrome, which often implies vertebral defects, from a bifid vertebra to hemivertebrae, or fused vertebrae. We describe a case of supernumerary lateral hemivertebra detected prenatally at 12 weeks of gestation and the ultrasonography specifics that lead to early and accurate diagnosis, monitoring during pregnancy, and follow-up at the 4-year period. The case is presented to specify the importance of an early assessment of fetal spine and diagnosis of various conditions, including hemivertebrae, considering the significant association with other anomalies (cardiovascular, urinary, skeletal, gastrointestinal, and central nervous systems), which are most commonly involved. Moreover, the need to counsel future parents on the risks implied by this anomaly is important for the obstetrician. We underline the inclusion of these types of congenital conditions in high-risk pregnancy because of the frequent association with high cesarean delivery rates, growth restriction, delivery before term, and higher morbidity rates.

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“…Early surgical treatment is widely suggested [ 8 , 10 , 15 ]. However, earlier hemivertebra resection with short segments fusion had the risk of less certain results in terms of correction and balance during the follow-up, as well as complications due to immaturity [ 7 , 15 , 16 ], such as pedicle fracture and displacement of screw, even damage of the spinal cord, nerve, vessel, wound complications because of the weak muscles and fascia of the infant. Furthermore, repeated or prolonged use of general anesthesia and sedatives in children under 3 years of age may affect the development of the child's brain [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes in children under 10 years old in the treatment of congenital scoliosis due to single nonincarcerated thoracolumbar hemivertebra: according to the age at surgery

Chen

Gao

et al. 2021

J Orthop Surg Res

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Purpose Hemivertebra is one of the common pathogenesis of congenital scoliosis. The timing of operation is undefined. Our study compared the surgical outcomes in children under age 10 years with scoliosis due to single nonincarcerated thoracolumbar hemivertebra according to the age at surgery. Methods From January 2009 to August 2017, we retrospectively investigated 34 consecutive cases of congenital scoliosis treated by posterior hemivertebra resection and fusion with pedicle screw fixation. All cases were divided into two groups according to the age at surgery and followed-up for at least 2 years, group 1 (≤ 5 years old), and group 2 (5 to 10 years old). Results The mean Cobb angle of the main curve was improved from 48.58° to 15.53° (68.05%) in group 1, and from 43.73° to 11.33° (75.43%) in group 2. The segmental curve was improved from 44.16° to 11.53° (74.64%) in group 1, and the segmental curve was consistent with the main curve in group 2. The mean segmental kyphosis was improved from 27.50° to 8.42° (67.40%) in group 1, and from 29.00° to 5.00° (84.73%) in group 2. Five patients developed distal adding-on, and four patients were found proximal junctional kyphosis during the follow-up. Conclusion Not all the deformities caused by single nonincarcerated thoracolumbar hemivertebra would progress greatly with the spinal growth. No significant statistical differences were found in the coronal and sagittal correction rate between the two groups. A limited delayed surgery after 5 years but before 10 years of age with close follow-up can achieve satisfied results.

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Emerging S-shaped curves in congenital scoliosis after hemivertebra resection and short segmental fusion

Cited by 21 publications

References 21 publications

Hemivertebra Resection and Spinal Arthrodesis by Single-Stage Posterior Approach in Congenital Scoliosis and Kyphoscoliosis: Results at 9.6 Years Mean Follow-up

Hemivertebra Resection and Spinal Arthrodesis by Single-Stage Posterior Approach in Congenital Scoliosis and Kyphoscoliosis: Results at 9.6 Years Mean Follow-up

First-Trimester Diagnosis of Supernumerary Hemivertebra

Surgical outcomes in children under 10 years old in the treatment of congenital scoliosis due to single nonincarcerated thoracolumbar hemivertebra: according to the age at surgery

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