Excision and short segment fusion of a double ipsilateral lumbar hemivertebrae associated with a diastematomyelia and fixed pelvic obliquity

Abstract

We report the surgical treatment course of a 4-year-old girl with congenital scoliosis, diastematomyelia and double adjacent hemivertebrae. She had a lumbar curve with an apparent pelvic obliquity. Simultaneous excision of double segmented sequential hemivertebra at the L3–L4 level and fusion with short-segment instrumentation was performed via a posterior approach. Intraoperative radiographs revealed satisfactory curve correction and 0° pelvic obliquity. Following the excision of double adjacent hemivertebrae, three adjacent nerve roots were placed in one intervertebral foramen bilaterally. Nevertheless, no neurological deficit was developed, and the patient was able to ambulate with a brace at day one. Pelvic balance and deformity correction were maintained with no implant failure at the fifth year follow-up. Excision of two ipsilateral adjacent hemivertebra and short-segment posterior fusion performed via posterior-only approach simultaneously is an effective, safe, and less invasive technique for the treatment of the described case.

3D printed templates improve the accuracy and safety of pedicle screw placement in the treatment of pediatric congenital scoliosis

“…For patients with congenital scoliosis treated at an early age (3–5 years), hemi-vertebrae excision and short segment fusion may be performed when there is a single or 2-level congenital vertebral defect [ 20 ]. Short segment fusion may reduce the number of segments that are fixed; however, this is often associated with instrumentation complications.…”

3D Printed Templates Improve the Accuracy and Safety of Pedicle Screw Placement in the Treatment of Pediatric Congenital Scoliosis

“…The conventional freehand method is associated with low accuracy of screw placement [11,12]. For patients with congenital scoliosis treated at an early age (3-5 years), hemi-vertebrae excision and short segment fusion may be performed when there is a single or 2level congenital vertebral defect [20]. Short segment fusion may reduce the number of segments that are…”

The 3D Printed Template Assists Accuracy and Safety of Screw Placement in the Treatment of Pediatric Congenital Scoliosis: A Case Control Retrospective Study

“…Especially in pediatric scoliosis patients, pedicle screw misplacement is more likely to occur due to the presence of small pedicles and severely rotated vertebrae. For congenital scoliosis patients at an early age (3-5 years), hemivertebra excision and short segment fusion are a safe and effective procedure for a single or twolevel congenital vertebral defect [17]. To reduce the xation of segments, short segment fusion ( xation of the vertebra above and below the hemivertebrae) is frequently performed.…”