[The efficacy and complications of posterior hemivertebra resection with monosegmental fusion for congenital scoliosis].

OBJECTIVE

To evaluate the efficacy and complications of posterior hemivertebra resection with monosegmental fusion in the treatment of congenital scoliosis.

METHODS

Thirty consecutive cases of congenital scoliosis managed by posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra were investigated retrospectively. Radiographs were reviewed to determine the coronal curve magnitude and sagittal alignment preoperatively, postoperatively and at last follow-up. Operative reports and patient charts were reviewed to record any perioperative and late complications.

RESULTS

The total number of resected hemivertebra was 30. Mean operation time was 193.8 min with average blood loss of 369.0 ml. The segmental scoliosis was corrected from 36.4° to 4.9° with a correction rate of 86.5%, and segmental kyphosis (difference to normal segmental alignment) from 21.2° to 6.6° with a correction rate of 68.9%. The trunk shift was improved from 17.1 to 8.8 mm. The correction of the compensatory cranial and caudal curve were 74.9% and 75.1%. There were 1 delayed wound healing, 2 pedicle cutting and 1 rod breakages. Radiolucent gaps were found on the lateral view in 2 cases without any sign of implant failure and correction loss.

CONCLUSIONS

Posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra allows for early intervention in very young children. Excellent correction in the frontal and sagittal planes can be obtained. And a short segment of fusion allows for normal growth in the unaffected parts of the spine. The most common complication is implant failure.