One-stage Posterior Hemivertebral Resection And Segmental Instrumentation In The Treatment Of Thoracolumbar Hemivertebra

BackgroundCongenital scoliosis is a spinal deformity caused by fetal spinal vertebral dysplasia and neonatal morbidity of which is estimated at 0.05 persent to 0.1 persent. Hemivertebrae are the most frequent cause of congenital scoliosis.They have growth potential similar to normal vertebra,creating wedge-shaped deformity that progresses during further spinal growth.In hemivertebrae,progression of the spinal deformity occurs as a result of unbalanced vertebral growth.Non-surgical treatments including bracing usually have been unsuccessful in preventing progression of the deformity,and surgical intervention is necessary for most cases with curve progression.There many surgical treatment for hemivertebra such as In situ fusion Convex hemiepiphysiodesis Hemivertebra resection and so on.Hemivertebra resection is the effective method to correct spinal deformities and restore spinal balance,which is the effective treatment of hemivertebra.ObjectiveTo evaluate the effect of one—stage posterior hemivertebral resection and segmental instrumentation in the treatment of congenital thoracolumbar hemivertebra.Material and methods9 children with hemivertebra underwent one-stage operation of posterior hemivertebral resection and segmental instrumentation with pedicle screw system between July 2005 to July 2008,the average age of the patients was 8.2 years(ranging 1-15 years).The pre and post-operative standing radiographic changes and at the final follow—up visit were measured.ResultsThe mean operative time was 140 minutes(100～240 minutes),the average blood loss was 675 milliliters(5OO～1200 ml).The average follow-up duration was 13 months(ranging 6-34 months).Preoperative scoliosis was corrected from 42.1°to 13.7°(correction rate 67.4%) and no loss of correction,and kyphosis was corrected from 26.3°to 11.2°(correction rate 53.6%) and no loss of correction.Trunk shift improved from 2.2cm to 1.2cm.and 1.3cm at the final follow—up visit.There are no severe complication was noted such as infection,spinal cord injury and so on.ConclusionOne—stage posterior hemivertebral resection mad segmental instrumentation with pedicle screw system in the treatment of congenital thoracolumbar hemivertebra can achieve a satisfactory result.