Wedge Hemivertebra Forward-Shifting Technique for Treatment of Congenital Kyphosis: Case Report, Technical Note, and Literature Review.

BACKGROUND

Congenital kyphosis due to wedge hemivertebra is an uncommon spinal deformity that could progressively develop into sagittal imbalance accompanied by subsequent neurologic deterioration if no intervention is performed. Numerous surgical techniques have been reported, since congenital kyphosis has shown no response to conservative treatments. Currently, osteotomy procedures, which are considered technically demanding and risky, have become the mainstream techniques for the correction of congenital kyphosis.

METHODS

We describe the use of a novel surgical procedure combining forward-shifting of anterior column of the wedge hemivertebra and circumferential fusion for treatment of congenital kyphosis secondary to a wedge hemivertebra in a case of a 13-year-old boy who showed a 49° angular kyphosis from T12 to L2 secondary to a wedge hemivertebra in L1.

RESULTS

The focal kyphosis was corrected to 5° with a correction rate of 89.8% after operation, and the sagittal balance was significantly preserved with no complication. Solid fusion was detected at the final follow-up.

CONCLUSIONS

This novel procedure, combining forward-shifting of anterior column of the wedge hemivertebra and circumferential fusion, is a feasible, effective, and safe technique for the treatment of some special type 1 congenital kyphosis cases, with a high correction rate and no major complications.