The natural history of congenital scoliosis. A study of two hundred and fifty-one patients.

McMaster, Michael J.; Ohtsuka, K

doi:10.2106/00004623-198264080-00003

Cited by 396 publications

(239 citation statements)

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“…Hemivertebra is the most frequent cause of congenital scoliosis. If left untreated, hemivertebra may lead to substantial spinal deformity [1][2][3]. Although hemivertebra excision for congenital scoliosis due to a single hemivertebra has been widely reported , we are unaware of previous reports of the treatment of unbalanced multiple hemivertebrae, and could not find any reference to it in a computerized search utilizing MED-LINE .…”

Section: Introductionmentioning

confidence: 99%

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Hemivertebrae resection for unbalanced multiple hemivertebrae: is it worth it?

et al. 2013

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Purpose To assess the correction effect of hemivertebra resection for unbalanced multiple hemivertebrae by measuring corresponding parameters in both coronal and sagittal planes on series posteroanterior and lateral radiographs and report the related complications. Methods Twelve children with unbalanced multiple hemivertebrae were operated on by hemivertebra resection through a combined anterior and posterior approach or a posterior-only procedure. Mean age at time of surgery was 9.8 years (range 2-14 years). They were retrospectively studied with a mean follow-up of 48.7 months (range 30-60 months). Results The mean Cobb angle of the main curve was 65.3°(range 45°-92°) before surgery and 13.8°(range 4°-30°) at the last follow-up. The correction rate was 80.0 % (range 65.5-92.4 %). The compensatory cranial curve was corrected from 25.8°(range 5°-53°) to 11.7°(range 0°-34°) with a correction rate of 65.9 % (range 33.3-100 %), and the compensatory caudal curve was corrected from 32.4°(range 17°-57°) to 7.1°(range 0°-20°) with a correction rate of 81.4 % (range 53.1-100 %). The angle of segmental kyphosis was 41.3°(range 12°-76°) before surgery and 17.0°(range -12°to 45°) at the final followup. The coronal imbalance was -1.0 cm (range -3.5 to 3 cm) before surgery and 0.0 cm (range -1.0 to 1.5 cm) at the most recent follow-up. The sagittal imbalance was 0.9 cm (range -3.2 to 3 cm) before surgery and 0.6 cm (range -3.0 to 3.5 cm) at the most recent follow-up. Complications including pedicle fractures, and pseudarthrosis were found in two patients (20 %). Conclusions In the patients with unbalanced multiple hemivertebrae, hemivertebra resection allows for excellent correction in both the coronal and sagittal planes, and great care should be taken to reduce the rate of complications.

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Section: Introductionmentioning

confidence: 99%

“…The natural history of congenital scoliosis has been well documented [1][2][3]. Hemivertebra is the most frequent cause of congenital scoliosis.…”

Section: Introductionmentioning

confidence: 99%

Hemivertebrae resection for unbalanced multiple hemivertebrae: is it worth it?

et al. 2013

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“…The lack of a mobile spine frequently results in early truncal decompensation and a large compensatory curve, which may progress with time [36]. Rigid congenital kyphoscoliosis in adults usually occur with functional impairment and neurologic complications, and pain is a common symptom [9,21,22,26].…”

Section: Introductionmentioning

confidence: 99%

A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases

Wang

Zhang

et al. 2008

Eur Spine J

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We report a multilevel modified vertebral column resection (MVCR) through a single posterior approach and clinical outcomes for treatment of severe congenital rigid kyphoscoliosis in adults. Transpedicular eggshell osteotomies and vertebral column resection are two techniques for the surgical treatment of rigid severe spine deformities. The authors developed a new technique combining the two surgical methods as a MVCR, through a single posterior approach, for surgical treatment of severe congenital rigid kyphoscoliosis in adults. Thirteen adult patients with severe rigid congenital kyphoscoliosis deformity were treated by a single posterior approach using a MVCR technique. The surgery processes included a onestage posterior transpedicular eggshell technique first, and then expanded the eggshell technique to adjacent intervertebra space through abrasive reduction of the vertebral cortices from inside out. All posterior vertebral elements were removed including the cortical vertebral bone around the neural canal. Range of resection of the vertebral column at the apex of the deformity included apical vertebra and both cephalic and/or caudal adjacent wedged vertebrae. Totally, 32 vertebrae had been removed in 13 patients, with 2.42 vertebrae being removed on average in each case. The average fusion extent was 7.69 vertebrae. Mean operation time was 266 min with average blood loss of 2,411.54 ml during operation. Patients were followed up for an average duration of 2.54 years. Deformity correction was 59% in the coronal plane (from 79.7°to 32.4°) postoperatively and 33.7°(57% correction) at 2 years followup. In the sagittal plane, correction was from preoperative 85.9°to 27.5°immediately after operation, and 32.0°at 2 years follow-up. Postoperative pain was reduced from preoperative 1.77 to 0.54 at 2 years follow-up in visual analog scale. SRS-24 scale was from 38.2 preoperatively to 76.9 at 2 years follow-up postoperative. Complications were encountered in four patients (30.7%) with transient neurology that spontaneously improved without further treatment within 3 months. MVCR technique through a single posterior approach is an effective procedure for the surgical treatment of severe congenital rigid kyphoscoliosis in adults.

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“…В качестве рентгенологических показателей оценки риска прогрес-сирования врожденной деформации позвоночника в разной степени зна-чимости учитываются морфологи-ческий вариант порока, нарастание величины деформации в градусах в год (по Cobb), локализация и коли-чество аномальных позвонков [2,7,13,15,16,23,24,28,30].…”

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