Correlation Analysis Of Surgicalage And Short-term Efficacy Of Congenital Scoliosis

Objective: Explore the correlation between age and the short-term efficacy of congenital scoliosis operation in children,to improve the understanding of the surgical treatment of the hemivertebra.Methods:In our study,30 cases diagnosed with congenital scoliosis caused by hemivertebra between February 2012 and April 2016 were investigated retrospectively,including 19 males and 11 females.The average age of them is 6.5 years old(2~15 years old).30 cases were divided into two groups according to the age of 4?5?6?7?8 years old respectively,each group was divided into higher age group and lower age group according to age.The short-term efficacy of each age group in lower age group and higher age group were compared.All patients underwent preoperative 3D CT examination before operation to accurately measure parameters of pedicle,and then treated by one-stage posterior hemivertebra resection combined with pedicle screw fixation.The operative time,amount of bleeding of per kilogram,preoperative and postoperativecorrection angle of lateral bending,amount of screw and loss of correction angle were recorded.Results : All the operations were successfully completed without serious neurological complications.All patients were followed up for 6~60months,with an average of 17 months.Pedicle screws was implanted from4 to 12,with an average of 5.All the screws were implanted successfully without complications such as screw loosening and rod fracture after operation.There was no significant difference in the correction rate of lateral bending in the higher age group and the lower age group at the age dividing point of 4?5?7 and 8 years old.The difference was statistically significant of 6,P=0.024<0.05.The operation time of the lower age group was(210.29±53.34)min,and that of the higher age group was(276.92±79.52)min,the difference is statistically significant(P<0.05);the amount of bleeding of per kilogram during the operation of the lower age group was(16.61±8.03)ml/kg,and that of the higher age group was(17.49±10.24)ml/kg,there is no statistical significance in the difference(P>0.05);the Cobb's angle of the lower age group before operation was(32.14 ±9.91)°,which was corrected to(10.49±4.41)° after surgery,thus the correction rate was(66.66±10.59)%;the Cobb's angle of the higher age group before operation was(37.52 ± 16.98)°,which was corrected to(15.16 ± 4.64)° after surgery,thus the correction rate was(56.02 ±13.80)%,the difference is statistically significant(P<0.05).Conclusion : It is feasible for children who were diagnosed with congenital scoliosis of hemivertebra to perform one-stage posterior hemivertebra resection combined with pedicle screw fixation,which can achieve ideal spinal correction effect.Orthopedic surgery should be performed early to relatively lighten the secondary spinal deformity and shorten the fixed segment during the operation.It is suggested that the orthopedics should be performed between 2 and 6 years old.