Yangpu Zhang1, Jincai Yang1, Lijin Zhou1, Aixing Pan1, Yong Hai2. 1. Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chao-Yang District, Beijing, 100020, China. 2. Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chao-Yang District, Beijing, 100020, China. zhangyp223@163.com.
Abstract
PURPOSE: To report the surgical experience of selective hemivertebrae resection for a case of congenital scoliosis with multiple hemivertebrae deformities. METHODS: A 14-year-old male presented with progressive rib hump, tilted torso and spine deformity was admitted in our department. No abnormalities were detected in neurological examination and the comprehensive imaging study demonstrated congenital scoliosis of multiple hemivertebrae in T5, T10, L1 and L3. Treatment of the patient commenced with a 10-day skin traction therapy prior to the surgery. Selective resection of hemivertebrae in T5 and L1 was performed with segmental fusion from T3 to L2. RESULTS: After surgical procedure, the patient achieved a good coronal and sagittal balance along with a good correction of the curve. 18-month postoperative follow-up showed no evidence of significant loss of correction. No device-related complication such as implant loosening or failure or neurologic complication occurred during the follow-up. Besides, patient's shoulder balance was further improved and coronal balance was maintained in a normal range. CONCLUSION: Many factors have to be considered in the clinical decision-making of congenital scoliosis with multiple hemivertebrae deformities patients. Much emphasis in this regard is laid on the type and location of the hemivertebrae as well as the patient's age. Selective hemivertebrae resection may be more suitable for such patients.
PURPOSE: To report the surgical experience of selective hemivertebrae resection for a case of congenital scoliosis with multiple hemivertebrae deformities. METHODS: A 14-year-old male presented with progressive rib hump, tilted torso and spine deformity was admitted in our department. No abnormalities were detected in neurological examination and the comprehensive imaging study demonstrated congenital scoliosis of multiple hemivertebrae in T5, T10, L1 and L3. Treatment of the patient commenced with a 10-day skin traction therapy prior to the surgery. Selective resection of hemivertebrae in T5 and L1 was performed with segmental fusion from T3 to L2. RESULTS: After surgical procedure, the patient achieved a good coronal and sagittal balance along with a good correction of the curve. 18-month postoperative follow-up showed no evidence of significant loss of correction. No device-related complication such as implant loosening or failure or neurologic complication occurred during the follow-up. Besides, patient's shoulder balance was further improved and coronal balance was maintained in a normal range. CONCLUSION: Many factors have to be considered in the clinical decision-making of congenital scoliosis with multiple hemivertebrae deformitiespatients. Much emphasis in this regard is laid on the type and location of the hemivertebrae as well as the patient's age. Selective hemivertebrae resection may be more suitable for such patients.