The Results of Hemivertebra Resection by the Posterior Approach in Children with a Mean Follow-Up of Five Years

Abstract

Aim To evaluate the radiologic and clinical results of patients who underwent deformity correction and stabilization for congenital spinal deformities using pedicle screws after hemivertebra resection. Material and Method Nine patients, mean age 9.2, who underwent posterior hemivertebrectomy and transpedicular fixation for congenital spinal deformity and had longer than five years of follow-up were evaluated retrospectively. The hemivertebrae were located in the thoracic region in 4 patients and thoracolumbar transition region in 5 patients. The patients were evaluated radiologically and clinically in the postoperative period. Results Mean length of follow-up was 64.2 months. The mean operating time was 292 minutes. The mean blood loss was 236 mL. The average hospitalization time was 7 days. The amount of correction on the coronal planes was measured as 31%. The mean segmental kyphosis angle was 45.7 degrees preoperatively and it was measured 2.7 degrees in the follow-up period. There were no statistically significant differences between the early postoperative period and final follow-up X-rays with respect to coronal and sagittal plane deformities. Conclusion The ability to obtain a sufficient and balanced correction in the cases accompanied by long compensator curvatures that have a structural character in hemivertebra may require longer fusion levels.

Effects of posterior hemivertebra resection and short segment fusion on the evolution of sagittal balance in children with congenital scoliosis

“…through a posterior approach in children with CS can correct the congenital deformity on both frontal and sagittal plane effectively, as already shown by previous studies [17,18,20,29,30]. Although sagittal plane local deformity correction is maintained over time, thoracic and lumbar sagittal balance does not reach normal values for age.…”

An Analysis of the Risk Factors for Adding-on Phenomena After Posterior Hemivertebral Resection and Pedicle Screw Fixation for the Treatment of Congenital Scoliosis Caused by Hemivertebral Malformation

“…In recent years, research has shown that an increasing number of surgeons are using simple posterior HV resection to treat HV deformities. In 2017, Erturer et al 4 evaluated the radiological and clinical effects of PHR and pedicle screw fixation in treating congenital spinal deformities. The correction rate of the malformation of the spinal coronal plane was 31%, and the average kyphotic angle was 45.7° preoperatively and 2.7° during follow-up.…”

“…Moreover, posterior HV resection is associated with a shorter operation time, less blood loss, and a lower incidence of complications. 4 In a multicenter trial, Yaszay et al 5 compared three surgical methods: hemiepiphysiodesis or in situ fusion, internal fixation fusion (the hemivertebra is not excised), and hemivertebra resection with internal fixation and fusion. For young patients, the correction effect of the posterior HV resection is better than the other two surgical methods, and it can improve the condition of the malformation, but it has an increased risk of complications over the other two surgical methods, including an increased incidence of neural injury.…”

Posterior hemivertebra resection without internal fixation in the treatment of congenital scoliosis in very young children

“…The most common hemivertebral deformity is caused by abnormal unilateral vertebral body formation (6), and fully segmented hemivertebrae and type III congenital scoliosis have early onset and rapid progression (1). Conservative treatment cannot prevent deformity progression, and some researchers recommend early surgical intervention (7)(8)(9). Early surgery in young children with congenital scoliosis can slow down or prevent further development of the deformity, thus allowing the unaffected part of the spine to grow normally (2).…”