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KMID : 0388720080150010001
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Journal of Korean Society of Spine Surgery
2008 Volume.15 No. 1 p.1 ~ p.8
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Posterior Hemivertebra Excision in Congenital Scoliosis
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Ahn Jong-Kuk
Kim Jin-Hyok
Kim Sung-Soo
Cho Beom-Cheol
Jung Nak-Young
Suk Se-Il
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Abstract
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Study Design: Retrospective study
Objectives: To evaluate the surgical outcome of congenital scoliosis with a hemivertebra treated by posterior hemivertebra excision and pedicle screw instrumentation.
Summary of Literature Review: Posterior hemivertebra excision can be accomplished through a single posterior approach, and excellent correction and outcome may be achieved.
Materials and Methods: Forty patients with one fully segmented hemivertebra treated by posterior hemivertebra excision with pedicle screw instrumentation were retrospectively analyzed after a minimum follow-up of 2 years (range 2~7.7 years). The mean age at surgery was 15.9 years (range 2.6~37.9 years). Preoperative and postoperative standing radiographs were used to assess radiographic parameters.
Results: The average number of vertebrae in the major curve was 4.2 (range 3~8), and the average flexibility was 29% (range 8~59%). The average length of fusion was 3.5 segments (range 1~6). The number of fused vertebrae had a positive correlation with age at the index surgery (r=0.345, p.0.05). Mean preoperative scoliosis of 48±12˚was corrected to a mean of 17±10˚(65% correction), and mean preoperative kyphosis of 46±18˚was corrected to a mean of 12±12˚at the most recent follow-up. The compensatory curve had a mean of 25±10˚preoperatively and spontaneously corrected to a mean of 8±8˚(70% correction) at the most recent follow-up. The mean operating time was 233±81 min, with an average blood loss of 2904 ml. There was neither crankshaft phenomenon nor iatrogenic spinal stenosis in 6 patients under the age of 5 years after an average follow-up of 6 years.
Conclusions: Posterior hemivertebra excision using pedicle screw instrumentation in congenital scoliosis due to a hemivertebra is a safe and effective procedure. Posterior hemivertebra excision at an early age may reduce the fusion length while avoiding the induction of iatrogenic spinal stenosis during follow-up.
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KEYWORD
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Congenital scoliosis, Hemivertebra, Posterior hemivertebra excision, Pedicle screw instrumentation
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