Single Posterior Hemivertebra Resection By Eggshell Technique In Treatment Of Congenital Scoliosis

Objective To evaluate the surgical efficacy, security and related complications of single posterior hemivertebra resection by eggshell technique in treatment of congenital scoliosis.Methods From January 2010 to January 2015, a total of 18 patients with congenital scoliosis caused by fully-segmented hemivertebra were retrospectively viewed. There were 11 males and 7 females in the group, with an average age of 10.8(range 3-23 years old). All of them underwent single posterior hemivertebrae resection by eggshell technique. Radiographs were reviewed to determine the Cobb angles of coronal curve and sagittal alignment preoperatively,postoperatively and at the latest follow-up in order to assess the correction effect of the foregoing procedure. Besides that, operation time,blood loss and complications were recorded as well.Results The average operation time was 228 minutes( range 155-270 minutes),and the average blood loss was 850 ml( range 100-3000 ml).The average fusion level was 3.3 segments( range 2-5 segments).The average follow-up period was 19 months( range 3-40 months).The correction rate of the coronal curve was 53.93%,as the average Cobb angle modifying from 40.07°preoperatively to 18.57°postoperatively. The correction rate of the sagittal alignment was 58.20%,as the average Cobb angle modifying from 22.73°preoperatively to9.50°postoperatively. At the latest follow-up, the coronal Cobb angle was 25.53°, with a 6.96°loss of correction, and the saggital Cobb angle was14.57°, with a 5.07°loss of correction. There were 2 implant failures and 1 incision infection in the group, with no neurological complication.Conclusion Congenital scoliosis caused by fully-segmented hemivertebra requires early surgical interference. Single posterior hemivertebrae resection by eggshell technique is capable of acquiring satisfying correction of coronal and saggital unbalance by directly removing the blaming hemivertebra, and it is of a low rate of complication. In a word, single posterior hemivertebrae resection by eggshell technique is an effective and safe way to treat congenital scoliosis.