Comparative Study Of Posterior Hemivertebra Resection And Internal Fixation In The Treatment Of Congenital Scoliosis Of Infant And Adolescence

Objective:To evaluate the surgical results of posterior hemivertebra resection and internal fixation with pedical screw in the treatment of congenital scoliosis caused by fully segmented hemivertebra of infant and adolescence.Methods:A total of 16 infant patients(Group 1) and 12 adolescence(Group 2) all the patients underwent one stage posterior with hemivertebra resection and internal fixation with pedical screw in the treatment of congenital scoliosis,were retrospectively analyzed.Group 1:7 males and 9 females. Surgery aged 12-27( 15.56+3.79)months.Preoperative Cobb angle 32 °- 45 °( 38.35°+ 3.44 °). Group 2: 5 males and 7 females.Surgery aged 16-22( 18.58+1.78) years old. Preoperative Cobb angle( 28°-72°)( 54.00°+11.08°).Results:Group 1:the operation time was145-210(185.00+25.32)minuts, the blood loss during operation was 220-580(375.00 +58.32)ml,blood transfusion 300-480(450.00+31.46)ml,the mean fusion level was 4-6(5.12 +0.75)segments. Two groups of patients were followed up for 12 to 36 months.Scoliosis was corrected from 38°to 12°with a correction rate of 68.40%.At the final follow- up, the coronal Cobb angle was 17°with a 5°loss of correction.No pseudoarthrosis and implant failure was noted. Perioperative complication included one delayed wound healing. There was no neurological complication.Group2:the operation time was 175-260( 275.00+31.12)minuts, the blood loss during operation was 580-1030 ml(765.00+ 136.63)ml,blood transfusion 600-120(850.00+56.35)ml,the mean fusion level was 6-10(8.00 +1.48)segments. Scoliosis was corrected from 54°to 47°with a correction rateof 13.0%.At the final follow- up, the coronal Cobb angle was 48°with a 2°loss of correction.Perioperative complication included two delayed wound healing, two neurological complication.Conclusion:One stage posterior hemivertebra resection has a good capability of correcting congenital kyphoscoliosis caused by a single hemivertebra. Comparative of posterior hemivertebra resection and internal fixation in the treatment of congenital scoliosis of infant and adolescence,infant surgery patients younger, good flexibility of the spine,orthopedic surgery good effect, short-segment fixation, surgery time is short.less blood loss during the operation, scoliosis Cobb angle correction significantly,fewer postoperative complications, surgery to reduce the damage caused by children, correct the spine to maintain balance, long-term follow-up of good effect.But according to adolescence,the scoliosis correcting result was not good because of the spinal deformity was stiff. So we can conclude that when the operation was done during the patient was 1 to 3 years old, we can get good results rather than the operation was done during the adolescent time.