Yong Huang1, Ganjun Feng2, Yueming Song3, Limin Liu4, Chunguang Zhou5, Lei Wang6, Zhongjie Zhou7, Xi Yang8. 1. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: huangyongod@163.com. 2. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: gjfeng_hx@163.com. 3. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: yuemingod_song@163.com. 4. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: liuliminod@163.com. 5. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: chunguang_zhou@163.com. 6. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: leiod_wang@163.com. 7. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: zhouzjod@163.com. 8. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: xiyangin88@163.com.
Abstract
OBJECTIVE: One-stage posterior hemivertebral resection has been proven to be an effective, reliable surgical option for treating congenital scoliosis due to a single hemivertebra. To date, however, no studies of treating unbalanced multiple hemivertebrae have appeared. This study evaluated the efficacy and safety of one-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae. PATIENTS AND METHODS: Altogether, we studied 15 patients with unbalanced multiple hemivertebrae who had undergone hemivertebral resection using the one-stage posterior approach with at least 2 years of follow-up. Clinical outcomes were assessed radiographically and with the Scoliosis Research Society-22 (SRS-22) score. Related complications were also recorded. RESULTS: The mean Cobb angle of the main curve was 62.4° (46°-98°) before surgery and 18.2° (9°-33°) at the most recent follow-up (average correction 73.3%). The compensatory cranial curve was corrected from 28.5° (11°-52°) to 9.1° (0°-30°) (average correction 70.0%). The compensatory caudal curve was corrected from 31.6° (14°-54°) to 6.9°(0°-19°) (average correction 79.1%). The segmental kyphosis/lordosis was corrected from 41.1° (-40° to 98°) to 12.3° (-25° to 41°) (average correction 65.5%). The mean growth rate of the T1-S1 length in immature patients was 9.8mm/year during the follow-up period. Health-related quality of life (SRS-22 score) had significantly improved. Complications include one wound infection and one developing deformity. CONCLUSION: One-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae provides good radiographic and clinical outcomes with no severe complications when performed by an experienced surgeon. Longer follow-up to detect late complications is obligatory.
OBJECTIVE: One-stage posterior hemivertebral resection has been proven to be an effective, reliable surgical option for treating congenital scoliosis due to a single hemivertebra. To date, however, no studies of treating unbalanced multiple hemivertebrae have appeared. This study evaluated the efficacy and safety of one-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae. PATIENTS AND METHODS: Altogether, we studied 15 patients with unbalanced multiple hemivertebrae who had undergone hemivertebral resection using the one-stage posterior approach with at least 2 years of follow-up. Clinical outcomes were assessed radiographically and with the Scoliosis Research Society-22 (SRS-22) score. Related complications were also recorded. RESULTS: The mean Cobb angle of the main curve was 62.4° (46°-98°) before surgery and 18.2° (9°-33°) at the most recent follow-up (average correction 73.3%). The compensatory cranial curve was corrected from 28.5° (11°-52°) to 9.1° (0°-30°) (average correction 70.0%). The compensatory caudal curve was corrected from 31.6° (14°-54°) to 6.9°(0°-19°) (average correction 79.1%). The segmental kyphosis/lordosis was corrected from 41.1° (-40° to 98°) to 12.3° (-25° to 41°) (average correction 65.5%). The mean growth rate of the T1-S1 length in immature patients was 9.8mm/year during the follow-up period. Health-related quality of life (SRS-22 score) had significantly improved. Complications include one wound infection and one developing deformity. CONCLUSION: One-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae provides good radiographic and clinical outcomes with no severe complications when performed by an experienced surgeon. Longer follow-up to detect late complications is obligatory.