Treatments On Congenital Hemi-Vertebrae Scoliosis Deformity Caused By 1/4 Free Lateral-Posterior Hemi-Vertebra

Objective:To discuss the effect of the spinal anterior and posterior treatments on congenital hemi-vertebrae scoliosis deformity caused by 1/4 free lateral-posterior hemi-vertebra.Methods:The clinical data of 21 patients (aged from 2 years old to 26 years old, mean age is 10 years old) with congenital scoliosis treatments, from February 2004 to March 2010, were retrospectively analyzed. Among them, 5 patients less than 3 years old underwent hemi-vertebra resection passing through the pectoral cavity and retroperitoneal incision, and corrected by traction, plaster after surgeries. Another 16 patients(older than 3 years old), who has pedicle X ray and CT-related parameters measured pre-operation, and C-Arm monitored in operation, underwent posterior hemi-vertebra resection, spinal pedicle screw internal fixation corrections. Cobb angle measured before and after surgery, patients were followed up for 2 months to 77 monthsResults:All patients had various degrees of scoliosis deformity, scoliosis angle improved from an average of 36.7°was corrected to 18.2°(correction rate is 50.1%); kyphosis angle was corrected from 37.9°to 14.2°(correction rate is 62.3 %).The effect of children less than 3 years old underwent correction, lateral bending angle from preoperative average of 35.2°was corrected to an average of 17°, kyphosis angle improved from 44.6°pre-operation to 18.2°, for children over 3 years old group, lateral bending angle was corrected from 37.3°pre-operation to 18.7°, kyphosis angle improved from 35.8°pre-operation to 13°, the average follow-up time was 36.9 months, no broken rods, decoupling and other postoperative complications.Conclusions:All correction methods, including anterior hemi-vertebra resection performed on patients with different age and different degree of deformity and corrected by traction, plaster after surgeries; or the application of posterior hemi-vertebra resection, spinal pedicle screw internal fixation corrections, had achieved satisfactory results. The measurement on preoperative pedicle X ray and CT-related parameters and intra-operative C-arm monitoring is extremely important to ensure the accuracy of pedicle screw implants.