Posterior Hemivertebra Resection With Transpedicular Instrumentation: Early Correction in Children Aged 1 to 6 Years

Abstract

Correction surgery of congenital scoliosis should be performed early, before the development of severe local deformities and secondary structural changes, especially in patients with expected deterioration. Posterior resection of the hemivertebra with transpedicular instrumentation allows for early intervention in very young children. Excellent correction in the frontal and sagittal planes, and a short segment of fusion allows for normal growth in the unaffected parts of the spine.

Accuracy of free-hand placement of thoracic pedicle screws in adolescent idiopathic scoliosis: how much of a difference does surgeon experience make?

“…As the safety and efficacy of pedicle screws are further established, spine surgeons increasingly use them for a variety of pathologies [5,8,23,31,32]. Thoracic pedicle screws provide numerous advantages over hook-hybrid constructs, including three-column fixation with improved coronal and axial correction [10,13,17,30] and lower revision rates [12].…”

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

“…Bollini [4] reported a long follow-up in cases of hemivertebra resection by a combined anterior and posterior approach performed in a single stage procedure. Ruf and Harms [5,6] used a hemivertebra resection by posterior resection only with transpedicular instrumentation in early correction even in very young patients; other authors have more recently described similar procedures [9,10].…”

Thoracic hemivertebra resection by posterior approach for congenital scoliosis

“…The aim of the treatment is to achieve a straight spine with respect to sagittal contour, and as short a construct as possible. This can be achieved by transpedicular instrumentation even in very young patients down to 1 year old [1]. In this case, pedicle fracture could be avoided by using the 3 rods technique and by doing simultaneous compression on pedicles and hooks applied on the posterior arch [2].…”

“…Many procedures have been traditionally described to treat this pathology including in situ posterior or anterior-posterior fusion with or without instrumentation, combined anterior and posterior convex hemiepiphysiodesis and hemivertebra excision with fusion. The latter technique can be performed by either a combined anterior and posterior approach, or a single posterior approach [1][2][3].…”