Michael Ruf1, Rubens Jensen, Jürgen Harms. 1. Department of Orthopedics and Traumatology, Center for Spinal Surgery, Klinikum Karlsbad-Langensteinbach, Germany. michael.ruf@kkl.srh.de
Abstract
STUDY DESIGN: Retrospective study with clinical and radiologic evaluation of hemivertebra resection in children with congenital cervical scoliosis. OBJECTIVE: Assessment of hemivertebra resection in the treatment of congenital cervical scoliosis. SUMMARY OF BACKGROUND DATA: To our knowledge, this is the first report on hemivertebra resection in the midcervical spine. METHODS: Three patients with torticollis due to a cervical hemivertebra were operated on by hemivertebra resection and fusion of the adjacent vertebrae. Resection was performed by a posterior-anterior (-posterior) approach. Mean age at time of surgery was 9 years 3 months. They were retrospectively studied with a mean follow-up of 4.8 years. RESULTS: Mean segmental Cobb angle at the hemivertebra was 29 degrees before surgery, 5 degrees after surgery, and 6 degrees at latest follow-up. Head tilt improved from 17 degrees before surgery to 1 degrees after surgery, and 3 degrees at latest follow-up. Bony fusion was achieved in all cases. There was weakness of the left deltoid muscle in 1 case due to C5 root compression by a facet screw, which resolved completely after revision with change of the screw. CONCLUSIONS: Resection of a cervical hemivertebra may be an option in the treatment of congenital cervical scoliosis. A good correction of the local deformity and a complete correction of head tilt are achieved. By early operation in young children, the development of severe secondary deformities in the upper thoracic spine can be avoided.
STUDY DESIGN: Retrospective study with clinical and radiologic evaluation of hemivertebra resection in children with congenital cervical scoliosis. OBJECTIVE: Assessment of hemivertebra resection in the treatment of congenital cervical scoliosis. SUMMARY OF BACKGROUND DATA: To our knowledge, this is the first report on hemivertebra resection in the midcervical spine. METHODS: Three patients with torticollis due to a cervical hemivertebra were operated on by hemivertebra resection and fusion of the adjacent vertebrae. Resection was performed by a posterior-anterior (-posterior) approach. Mean age at time of surgery was 9 years 3 months. They were retrospectively studied with a mean follow-up of 4.8 years. RESULTS: Mean segmental Cobb angle at the hemivertebra was 29 degrees before surgery, 5 degrees after surgery, and 6 degrees at latest follow-up. Head tilt improved from 17 degrees before surgery to 1 degrees after surgery, and 3 degrees at latest follow-up. Bony fusion was achieved in all cases. There was weakness of the left deltoid muscle in 1 case due to C5 root compression by a facet screw, which resolved completely after revision with change of the screw. CONCLUSIONS: Resection of a cervical hemivertebra may be an option in the treatment of congenital cervical scoliosis. A good correction of the local deformity and a complete correction of head tilt are achieved. By early operation in young children, the development of severe secondary deformities in the upper thoracic spine can be avoided.
Authors: Alexander A Theologis; Kate D Bellevue; Erion Qamirani; Christopher P Ames; Vedat Deviren Journal: Eur Spine J Date: 2016-12-28 Impact factor: 3.134
Authors: Charles E Mackel; Ajit Jada; Amer F Samdani; James H Stephen; James T Bennett; Ali A Baaj; Steven W Hwang Journal: Childs Nerv Syst Date: 2018-08-04 Impact factor: 1.475