Posterior approach lumbar and thoracolumbar hemivertebra resection in congenital scoliosis in children under 10 years of age: results with 3 years mean follow up

Crostelli, Marco; Mazza, Oscar; Mariani, Massimo

doi:10.1007/s00586-013-2933-z

Cited by 44 publications

(43 citation statements)

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“…Early or even prophylactic hemivertebra resection was recommended to stop the development of the local deformity and to prevent the longer fusion extending to the advanced secondary structural curves [10][11][12][13]. The modern transpedicular instrumentation could provide the short and sufficiently rigid stabilization in such patients, thereby avoiding wider distractions of spinal growth and mobility [11,16].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, single-stage posterior hemivertebra resection and short fusion has gradually become the mainstream treatment for the congenital scoliosis of fully segmented nonincarcerated hemivertebra [4,[10][11][12][13]16]. Early or even prophylactic hemivertebra resection was recommended to stop the development of the local deformity and to prevent the longer fusion extending to the advanced secondary structural curves [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…The single-stage posterior hemivertebra resection with short segmental pedicle screw fixation has demonstrated satisfactory deformities correction and rigid stabilization even in very young patients [10][11][12][13]. Behind these successful results, the potential complications, especially postoperative progressive deformities, have been given more and more attention in recent literatures [8,12,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…No spinal stenosis or neurologic deficits was found in the follow-up. Crostelli et al reported 15 cases with posterior lumbar or thoracolumbar hemivertebra with mean follow-up of 40 months, and the youngest patient treated by this procedure was 18 months old at the time of surgery [ 21 ]. No major complications emerged and only one pedicle fracture occurred.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes and complications of posterior hemivertebra resection in children younger than 5 years old

et al. 2016

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BackgroundThere have been many reports on posterior hemivertebra resection. However, there were few articles in very young cases. This is a clinical retrospective study to evaluate the complications and efficacy of posterior hemivertebra resection in very young cases.MethodsFrom January 2003 to January 2012, 39 consecutive cases of congenital scoliosis with hemivertebra were retrospectively investigated in our hospital, including 18 females and 21 males, aged from 21 to 65 months old (average 42.4 months). All the cases underwent posterior hemivertebra resection with transpedicular instrumentation. Clinical charts and radiographs of spine were retrospectively reviewed to record complications and outcomes postoperatively and at the latest follow-up.ResultsMean operation time was 186.4 min (90–280 min) with average blood loss of 306.6 (100–700) ml. The total number of hemivertebrae resected was 43, including one hemivertebra in 35 cases and two hemivertebrae in 4 cases. The mean number of fused segments was 3.4, including 22 cases (56.4 %) with bisegmental fusion and 4 cases with mesh cage. Average follow-up period was 5.4 (3 to 11) years. There was a mean improvement rate of 83.6 % in the segmental scoliosis from 38.4° before surgery to 6.3° after operation and a mean improvement rate of 81.9 % in segmental kyphosis from 17.1° to 3.2° over the same time. The spontaneous correction rates of the compensatory cranial curve and compensatory caudal curve were 65.7 and 66.9 %, respectively. There were three complications (two cases),one pedicle fractures, one rod breakages, and one additional surgery for curve progression. Besides these, two additional surgeries (two cases) were performed to remove the instrumentation for pedicle elongation in the follow-up. There was no neurological complication.ConclusionsPosterior hemivertebra resection with transpedicular instrumentation is a safe and effective procedure in very young congenital scoliosis cases. Earlier surgeries can achieve short fusion and save more mobile segments. However, complications associated with implants and spinal growth still remain major concerns.

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“…The de nitive treatment of the congenital kyphoscoliosis caused by HV should include removal of HV. Recently, HV excision via posterior approach or single level apical osteotomy in pediatrics has been reported as the choice of treatment with successful results [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

long-term results after the one-stage posterior-only surgical correction of thoraco-lumbar kyphoscoliosis in congenital spine deformity caused by two ipsilateral hemi-vertebrae

Xue

Zhao

Mao

et al. 2020

Preprint

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Background Two ipsilateral hemivertebrae is less common and presents severe growth imbalance produced by the vertebral anomalies. However, there is a paucity of reports regarding this double ipsilateral thoracolumber hemivertebrae. The purpose was to evaluate the long-term outcomes of the one-stage posterior-only surgical correction of thoraco-lumbar kyphoscoliosis caused by two ipsilateral hemi-vertebrae. Methods From 2006 to 2014, a total of 14 consecutive pediatric patients with congenital thoraco-lumbar kyphoscoliosis due to two ipsilateral hemivertebrae were treated by posterior excision of hemivertebrae with short segment fusion. The following parameters were measured: coronal segmental curve, cranial and caudal compensatory curve, segmental kyphosis, lumbar lodorsis, trunk shift, apical vertebra translation and sagittal vertical axis. These results were compared and evaluated in preoperative, immediately postoperative and at the final follow-up. All patients had a minimum of 5 years of follow-up period. Results The mean age at surgery was 11.1 ± 4.8 years (2yos to 17yos). The mean follow-up period was 80.2 ± 19.4 months (60mons to 117mons). There was a mean improvement of 74.2% in the segmental curve from a mean angle of 64.1° before surgery to 15.8° at the latest follow-up. The cranial and caudal curve improved of 69.8% and 69.0% from 25.6° to 7.7°, 26.9 to 8.2, respectively. The mean thoracolumbar kyphosis was 59.9° before and 13.6° after surgery, 20.8° at the final follow-up. Alignment in the coronal and sagittal plane was either maintained or improved within normal values in all patients. Conclusions Good correction and spinal balance can be achieved by posterior-only hemivertebrectomy in patients with thoracolumbar kyphocsoliosis caused by two ipsilateral hemivertebra. The complication of neurological injury is low but a technically demanding procedure. More attention should be paid in residual curve progression after surgery.

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Posterior approach lumbar and thoracolumbar hemivertebra resection in congenital scoliosis in children under 10 years of age: results with 3 years mean follow up

Cited by 44 publications

References 20 publications

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

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

Surgical outcomes and complications of posterior hemivertebra resection in children younger than 5 years old

long-term results after the one-stage posterior-only surgical correction of thoraco-lumbar kyphoscoliosis in congenital spine deformity caused by two ipsilateral hemi-vertebrae

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