Effects of one-stage posterior hemivertebrectomy for hemivertebral imbalance on spinal imbalance and shoulder balance: A retrospective study

Abstract

Abstract Background One-stage posterior hemivertebrectomy is widely used for the treatment of hemivertebral-induced scoliosis. However, reports on posterior hemivertebrectomy evaluating hemivertebral-induced spinal imbalance and shoulder balance remain scarce. This study aimed to retrospectively analyze the effects of one-stage posterior hemivertebrectomy on spinal imbalance and shoulder balance. Methods Clinical data of 49 patients with scoliosis caused by congenitally imbalanced hemivertebra who underwent posterior hemivertebrectomy between January 2018 and March 2021 were evaluated. Radiographic parameters included sagittal Cobb angle, total main Cobb angle, coronal balance, T1 tilt angle, clavicle angle (CA), shoulder lengthdifference (RSH), T1–S1 length, sagittal kyphosis, thoracic kyphosis, lumbar lordosis, sagittal vertical alignment, L1 pelvic incidence angle, sacral inclination angle, and pelvic incidence angle. After descriptive analysis, the demographic and radiological data were compared. Results The preoperative RSH, CA, and T1 tilt angles of the shoulder imbalance group were significantly different from those of the shoulder balance group (P < 0.001). After surgical treatment, shoulder imbalance was significantly improved at the last follow-up than before surgery (P < 0.05). At the last follow-up, a significant difference in the T1 tilt angle was observed between the shoulder imbalance group and shoulder balance group (P < 0.05); however, no significant differences in the RSH and CA were observed between the two groups. Surgical treatment may significantly improve shoulder imbalance caused by imbalanced hemivertebral. Additionally, thoracic and lumbar hemivertebrectomy had a greater impact on shoulder balance, and lumbar hemivertebrectomy was more likely to cause coronal and sagittal imbalances. Conclusion In patients with congenital scoliosis caused by imbalanced hemivertebra, posterior hemivertebrectomy combined with short-segment pedicle screw fixation can provide good correction of scoliotic curve, coronal and sagittal plane imbalances, and shoulder imbalance. No serious complications were observed.