Partial Hemivertebra Resection (Grade 4 Osteotomy) for Congenital Scoliosis: A Comparison with Radical Hemivertebra resection

Liu, Dun; Shi, Bo; Shi, Benlong; Yang, Li; Xia, Sanqiang; Liu, Zhen; Zhu, Zezhang; Qiu, Yong

doi:10.1016/j.wneu.2019.07.070

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…of other systems, and the age of the patient. Hemivertebra resection can remove teratogenic factors from the root and achieve a good orthopedic effect (8). Hemivertebra resection was first reported by Royle in 1928.…”

Section: Discussionmentioning

confidence: 99%

“…A hemivertebra resection via the anterior-posterior approach and via the posterior approach are commonly used due to these procedures' ability to directly remove teratogenic factors. At present, a one-stage hemivertebra resection via the posterior approach combined with bilateral pedicle screw internal fixation as the treatment of CS is often reported (5)(6)(7)(8), but there are few studies on this treatment method including unilateral internal fixation. This study was designed to compare the curative efficacy of hemivertebra resection via the posterior approach assisted with unilateral and bilateral internal fixation in the treatment of CS.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Curative Efficacy of Hemivertebra Resection via the Posterior Approach Assisted With Unilateral and Bilateral Internal Fixation in the Treatment of Congenital Scoliosis

Liu

et al. 2022

Front. Surg.

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ObjectiveThis study aimed to compare the curative efficacy of hemivertebra resection via the posterior approach assisted with unilateral and bilateral internal fixation in the treatment of congenital scoliosis (CS).MethodsIn this study, 29 children (15 males and 14 females), who underwent hemivertebra resection via the posterior approach and received internal fixation from November 2005 to September 2018, were analyzed retrospectively. The age of these patients ranged from 0.9 to 15 years, with an average of 3.8 years. The follow-up duration ranged from 2 to 12.3 years, with an average of 5.7 years. The patients in group A received unilateral internal fixation, and those in group B received bilateral internal fixation. The operation duration, bleeding volume, and complications during the operation, as well as the Cobb angles of scoliosis and kyphosis before and after the operation and at the last follow-up, were compared between the two groups.ResultsIn group A, the operation duration was 207.4 ± 54.5 min, and the bleeding volume was 215.3 ± 75.4 ml; in group B, the operation duration was 249.5 ± 51.0 min, and the bleeding volume was 291.3 ± 115.6 ml (P < 0.05). The Cobb angles of segmental scoliosis, segmental kyphosis, cephalic compensatory curve, and caudal compensatory curve were significantly improved in the two groups after operation and at the last follow-up (P < 0.05). The post-operative correction rate of the scoliosis Cobb angle was 67.2% in group A and 79.5% in group B; and the difference was statistically significant (P < 0.05). At the last follow-up, the correction rate of the scoliosis Cobb angle was 72.7% in group A and 76.2% in group B (P > 0.05). After the operation and at the last follow-up, the correction rates of kyphosis were 83.1 and 79.6% in group A and 71.8 and 65.5% in group B (P > 0.05).ConclusionHemivertebra resection via posterior approach with unilateral internal fixation can also achieve the effect of bilateral internal fixation in the treatment of CS. It is able to preserve a certain degree of contralateral spinal growth potential and is a feasible method.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the Curative Efficacy of Hemivertebra Resection via the Posterior Approach Assisted With Unilateral and Bilateral Internal Fixation in the Treatment of Congenital Scoliosis

Liu

et al. 2022

Front. Surg.

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“…Though the instinctive experience implied that high grade of osteotomy could provide high correction rates, some evidence, however, showed limited increases in correction rate from SRS‐Schwab Grade 4 osteotomy to VCR(s). Liu et al 10 . reported similar correction of Cobb angle in congenital scoliosis patients undergoing radical hemivertebrae resection as compared to those undergoing VCR.…”

Section: Discussionmentioning

confidence: 82%

“…It has been widely accepted that 3-column osteotomy techniques are the mainstay treatments for patients with moderate to severe CK, during which the vertebral column resection (VCR) of unsegmented vertebra is traditionally performed. 6,7 Though satisfactory clinical and radiographic outcomes could be expected in most patients undergoing VCR(s), [8][9][10][11][12] several inherent defects such as over-shorting of spinal cord, the necessary of anterior support and massive blood loss were obstacles for this challenging procedure. 5,13,14 Recently, Shi et al 8 proposed that the SRS-Schwab Grade 4 osteotomy could be effectively applied in CK patients.…”

Section: Introductionmentioning

confidence: 99%

Posterior Corrective Surgery for Type II Congenital Kyphosis: SRS‐Schwab Grade 4 Osteotomy or Vertebral Column Resection?

Ma,

Shi,

Liu

et al. 2024

Orthopaedic Surgery

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ObjectiveSurgical decision‐making for congenital kyphosis (CK) with failure of anterior segmentation (type II) has been contradictory regarding the trade‐off between the pursuit of correction rate and the inherent risk of the osteotomy procedure. This study was designed to compare the clinical and radiographic measurement in type II CK underwent SRS‐Schwab Grade 4 osteotomy and vertebral column resection (VCR), the most‐adapted osteotomy techniques for CK, and to propose the strategy to select between the two procedures.MethodsThis retrospective observational comparative study evaluated surgical outcomes in type II CK patients underwent VCR or SRS‐Schwab Grade 4 osteotomy at our institution between January 2015 and January 2020. Patients operated with VCR and SRS‐Schwab Grade 4 osteotomy were allocated to Group 1 and Group 2 respectively. Radiographic parameters and SRS‐22 quality of life metrics were assessed at pre‐operation, post‐operation, and during follow‐up visits for both groups, allowing for a comprehensive comparison of surgical outcomes.ResultsThirty‐one patients (19 patients in Group 1 and 12 patients in Group 2) aged 16.3 ± 10.4 years were recruited. Correction of segmental kyphosis was similar between groups (51.1 ± 17.6° in Group 1 and 48.4 ± 19.8° in Group 2, p = 0.694). Group 1 had significantly longer operation time (365.9 ± 81.2 vs 221.4 ± 78.9, p < 0.001) and more estimated blood loss (975.2 ± 275.8 ml vs 725.9 ± 204.3 mL, p = 0.011). Alert event of intraoperative sensory and motor evoked potential (SEP and MEP) monitoring was observed in 1 patient of Group 2. Both groups had 1 transient post operative neurological deficit respectively.ConclusionSRS‐Schwab Grade 4 osteotomy was suitable for kyphotic mass when its apex is the upper unsegmented vertebrae or the neighboring disc, or when the apical vertebrae with an anterior/posterior (A/P) height ratio of vertebral body higher than 1/3. VCR is suitable when the apex is located within the unsegmented mass with its A/P height ratio lower than 1/3. Proper selection of VCR and SRS‐Schwab Grade 4 osteotomy according to our strategy, could provide satisfying radiographic and clinical outcomes in type II CK patients during a minimum of 2 years follow‐up. Patients undergoing VCR procedure might have longer operation time, more blood loss and higher incidence of peri‐ and post‐operative complications.

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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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Partial Hemivertebra Resection (Grade 4 Osteotomy) for Congenital Scoliosis: A Comparison with Radical Hemivertebra resection

Cited by 8 publications

References 14 publications

Comparison of the Curative Efficacy of Hemivertebra Resection via the Posterior Approach Assisted With Unilateral and Bilateral Internal Fixation in the Treatment of Congenital Scoliosis

Comparison of the Curative Efficacy of Hemivertebra Resection via the Posterior Approach Assisted With Unilateral and Bilateral Internal Fixation in the Treatment of Congenital Scoliosis

Posterior Corrective Surgery for Type II Congenital Kyphosis: SRS‐Schwab Grade 4 Osteotomy or Vertebral Column Resection?

First-Trimester Diagnosis of Supernumerary Hemivertebra

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