Surgical outcomes following hemivertebrectomy in congenital scoliosis: a systematic review and observational meta-analysis

Barik, Sitanshu; Mishra, Dipun; Gupta, Tushar; Yadav, Gagandeep; Kandwal, Pankaj

doi:10.1007/s00586-021-06812-5

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…For hemivertebraeinduced CS, posterior hemivertebra resection combined with segmental fusion was the most common choice of surgery. Its correction rate varied from 46 to 87% (26)(27)(28)(29)(30)(31)(32)(33)(34)(35). The frequency of complications ranged from 0 to 41% (27, 28,32,33,[35][36][37][38][39][40][41][42] and complications included wound infection, addingon phenomenon, pseudoarticulation formation, postoperative progression of scoliosis, the offset of the internal fixation, and pedicle fractures.…”

Section: Discussionmentioning

confidence: 99%

Molecular identification of T-box transcription factor 6 and prognostic assessment in patients with congenital scoliosis: A single-center study

et al. 2022

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BackgroundCongenital scoliosis (CS) is characterized by vertebral malformations. The precise etiology of CS is not fully defined. A compound inheritance of TBX6 was identified in 10% of patients with CS in Han Chinese and formed a distinguishable subtype named TBX6-associated congenital scoliosis (TACS).MethodsTo investigate the variants and risk haplotype of TBX6, we recruited 121 patients with CS at Beijing Children’s Hospital. We collected the clinical characteristics and surgical treatment options and followed their postoperative prognoses.ResultsEight patients (6.6%) were molecularly diagnosed with TACS and carried the previously defined pathogenic TBX6 compound heterozygous variants. All the eight patients with TACS had the typical TACS clinical feature of hemivertebrae in the lower part of the spine. These patients received posterior hemivertebra resection combined with segmental fusion. Follow-ups revealed satisfactory correction without postoperative complications.ConclusionWe observed a 6.6% prevalence of TACS in our CS cohort. Follow-ups further highlighted that surgical treatment of hemivertebra resection combined with segmental fusion performed well with prognosis for patients with TACS. This could provide valuable information for CS individuals with compound heterozygosity in TBX6.

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Section: Discussionmentioning

confidence: 99%

Molecular identification of T-box transcription factor 6 and prognostic assessment in patients with congenital scoliosis: A single-center study

et al. 2022

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“…Posterior HV resection produces less trauma and causes fewer complications than anteroposterior approach. 7,20 For most patients, it is not necessary to resect all hemivertebrae, and selective hemivertebrectomy has been used to treat MHV deformities. 21,22 In general, the hemivertebra that has an obvious influence on scoliosis, kyphosis, or progression should be excised first.…”

Section: Common Presentation Of Multiple Hemivertebrae and Associated...mentioning

confidence: 99%

Multiple Hemivertebrae: The Natural History and Treatment of 50 Patients

Wang

Song

et al. 2023

Orthopaedic Surgery

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Objective Multiple hemivertebrae (MHV) is defined as three or more hemivertebrae, and is relatively uncommon among patients with congenital scoliosis. This study aimed to compare the natural history of different kinds of MHV and describe the surgical outcome of MHV. Methods In this retrospective cohort study, a total of 50 patients diagnosed with MHV were enrolled from June 2007 to June 2018. The medical records and radiographs of these patients were reviewed to summarize the characteristics of MHV. Patients with MHV were divided into the unbalanced (UB) group, partially unbalanced (PUB) group, and completely balanced (CB) group. Medical records and radiographs of MHV patients were reviewed to collect HV position, natural history, coronal and sagittal parameters. A Mann–Whitney U test was used to compare the radiographical data, such as the cobb angle of main curve and secondary curve, and Fisher's exact test was used to compare the patients in different kinds of MHV with surgical indication or not. Results The average number of hemivertebrae was 3.6 and the average main curve was 57.5°. Twenty‐four of 50 patients had associated anomalies, including four patients with sacral agenesis, one with tetralogy of Fallot, two with congenital imperforate anus, and 17 with Klippel‐Feil syndrome. In 22 patients who underwent MRI imaging, three patients had mild syringomyelia and three patients had diastematomyelia. The UB and PUB groups had a larger main curve and compensatory curve than the CB group. Of the 25 patients with follow‐up before surgery, the curve progression rate was highest in the UB group (12.1°/year) but similar in the PUB group (4.2°/year) and CB group (3.6°/year). All patients in the UB and PUB group met the criteria for surgery. In contrast, only 10 of 23 patients in the CB group had surgical indications. Eighteen of the 37 patients with surgical indications chose to undergo surgery and the correction rate of the main curve was 51.4%. Conclusions Early surgical intervention should be considered for most patients with UB or PUB MHV. For patients with CB MHV, surgical treatment may not be urgently needed at the first visit. Posterior hemivertebrectomy could be used for the treatment of MHV with satisfying radiographic outcome.

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“…The inclusion criteria were as follows: (1) diagnosis of congenital CS with single HV deformity; (2) with HV in the thoracic or lumbar spine; (3) one-stage posterior HV resection and bilateral pedicle screw xation; (4) xed segment of ≤ 6 vertebral bodies; and (5) follow-up time of ≥ 12 months. The exclusion criteria were as follows: (1) anterior HV resection or combined anterior and posterior HV resection; (2) treatment with the growing rod technique; (3) structural CS or kyphosis in other parts of the spine; (4) underwent previous spinal orthopedic surgery; (5) incomplete clinical and imaging data; and (6) follow-up time of < 12 months. The surgical indications for HV resection in this study were a Cobb angle or sagittal kyphosis angle of ≥ 25° with deformity progression of > 5° within 6 months or failure of conservative treatment.…”

Section: Case Collectionmentioning

confidence: 99%

“…CS is generally classi ed into three types, namely congenital, syndromic, and idiopathic. Hemivertebra (HV) formed by abnormal vertebral body development is an important cause of congenital CS [4,5]. HV produces a wedge-shaped deformity in both the sagittal and coronal planes, which adversely affects spinal growth and development.…”

Section: Introductionmentioning

confidence: 99%

“…At present, surgical methods related to HV include in situ spinal fusion, Smith-Peterson osteotomy, HV resection, and spinal resection, and even anterior complementary fusion [6, 12,13]. Royle rst described HV resection for the treatment of patients with CS in 1928 [5]. HV resection has been widely used for the treatment of patients with HV-induced CS; however, reports of surgical management to evaluate HV-induced spinal imbalance and shoulder balance remain scarce.…”

Section: Introductionmentioning

confidence: 99%

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Effects of one-stage posterior hemivertebrectomy for hemivertebral imbalance on spinal imbalance and shoulder balance: A retrospective study

Chen

Lei

Zhang

et al. 2022

Preprint

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Background One-stage posterior hemivertebrectomy is widely used for the treatment of hemivertebral-induced scoliosis. However, reports on posterior hemivertebrectomy evaluating hemivertebral-induced spinal imbalance and shoulder balance remain scarce. This study aimed to retrospectively analyze the effects of one-stage posterior hemivertebrectomy on spinal imbalance and shoulder balance. Methods Clinical data of 49 patients with scoliosis caused by congenitally imbalanced hemivertebra who underwent posterior hemivertebrectomy between January 2018 and March 2021 were evaluated. Radiographic parameters included sagittal Cobb angle, total main Cobb angle, coronal balance, T1 tilt angle, clavicle angle (CA), shoulder lengthdifference (RSH), T1–S1 length, sagittal kyphosis, thoracic kyphosis, lumbar lordosis, sagittal vertical alignment, L1 pelvic incidence angle, sacral inclination angle, and pelvic incidence angle. After descriptive analysis, the demographic and radiological data were compared. Results The preoperative RSH, CA, and T1 tilt angles of the shoulder imbalance group were significantly different from those of the shoulder balance group (P < 0.001). After surgical treatment, shoulder imbalance was significantly improved at the last follow-up than before surgery (P < 0.05). At the last follow-up, a significant difference in the T1 tilt angle was observed between the shoulder imbalance group and shoulder balance group (P < 0.05); however, no significant differences in the RSH and CA were observed between the two groups. Surgical treatment may significantly improve shoulder imbalance caused by imbalanced hemivertebral. Additionally, thoracic and lumbar hemivertebrectomy had a greater impact on shoulder balance, and lumbar hemivertebrectomy was more likely to cause coronal and sagittal imbalances. Conclusion In patients with congenital scoliosis caused by imbalanced hemivertebra, posterior hemivertebrectomy combined with short-segment pedicle screw fixation can provide good correction of scoliotic curve, coronal and sagittal plane imbalances, and shoulder imbalance. No serious complications were observed.

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Surgical outcomes following hemivertebrectomy in congenital scoliosis: a systematic review and observational meta-analysis

Cited by 9 publications

References 40 publications

Molecular identification of T-box transcription factor 6 and prognostic assessment in patients with congenital scoliosis: A single-center study

Molecular identification of T-box transcription factor 6 and prognostic assessment in patients with congenital scoliosis: A single-center study

Multiple Hemivertebrae: The Natural History and Treatment of 50 Patients

Effects of one-stage posterior hemivertebrectomy for hemivertebral imbalance on spinal imbalance and shoulder balance: A retrospective study

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