Affiliation:
1. Peking Union Medical College Hospital
Abstract
Abstract
Objective: To describe the technique and evaluate the results of “skipping” posterior hemivertebra resection with short segmental fusion for the treatment of progressive complex congenital spinal deformities due to nonadjacent hemivertebrae.
Methods: This study was a retrospective case series. Twelve patients (M/6, F/6) with congenital scoliokyphosis due to nonadjacent fully segmented hemivertebrae and with an average age of 4.6 (3-9) years were enrolled. Whole standing spine radiographs were used to measure the Cobb angle of the segmental curve and the compensatory curve; segmental kyphosis; thoracic kyphosis; lumbar lordosis; trunk shift; sagittal vertical alignment; and T1-S1 length before surgery, after surgery and at the latest follow-up evaluation. The hemivertebral location, fused segment, operation time and blood loss were assessed.
Results: All patients were followed for at least 2 years. The average number of fused segments was 2.6 for each patient and 1.3 for each hemivertebra. The segmental scoliosis measurement was 43.0° before surgery, 4.7° after surgery and 7.8° at the latest follow-up evaluation. Segmental kyphosis measurements improved from 15.4° to 6.5°. The correction of the compensatory cranial and caudal curves was 86.7% and 83.5%, respectively. Trunk shift improved from 22.3 mm to 7.9 mm. The T1-S1 length was 25.3 cm before surgery, 27.5 cm after surgery, and 34.7 cm at the latest follow-up evaluation. Revision surgery was indicated for 2 patients who developed decompensation during the follow-up period.
Conclusions: “Skipping” posterior hemivertebra resection with short segmental fusion could provide satisfactory correction with limited fusion. However, decompensation may occur during follow-up. The prognosis of the discs between two fusion masses needs to be evaluated in the future.
Publisher
Research Square Platform LLC