Department of Orthopaedic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
Department of Orthopaedic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
World Neurosurg. 2021 Jul;151:e693-e699. doi: 10.1016/j.wneu.2021.04.095. Epub 2021 May 1.
To compare the clinical and radiologic outcomes of patients with different 3-dimensional (3D) hemivertebra morphologies undergoing posterior-only hemivertebra resection and fusion.
The files of patients with congenital scoliosis (CS) due to single hemivertebra undergoing posterior-only hemivertebra resection and fusion from January 2010 to January 2018 were reviewed. After evaluating the 3D computed tomography images, CS patients were divided into a unison hemivertebra group and a discordant hemivertebra group. Clinical outcomes, radiologic outcomes, and incidence of complications were compared.
A total of 42 consecutive patients with CS patients due to a single hemivertebra undergoing posterior-only hemivertebra resection and fusion were included in this study. The Cobb angle of the segmental curve was significantly improved postoperatively and at the last follow-up in both groups (all P < 0.05). At both postoperation and the last follow-up, no significant differences were found in the incidence of complications, Cobb angle of the segmental curve, correction rate of the segmental curve, or other radiologic outcomes between the unison hemivertebra group and discordant hemivertebra group (all P > 0.05). Compared with the unison hemivertebra group, increased operation time (P = 0.006) and intraoperative blood loss (P = 0.037) were found in the discordant hemivertebra group.
For CS patients with unison hemivertebra or discordant hemivertebra, satisfactory radiologic results were obtained by posterior-only hemivertebra resection and fusion. In terms of surgery, the radiologic outcomes of discordant hemivertebra patients were similar to those of unison hemivertebra patients, but discordant hemivertebrae could easily result in longer operation time and more intraoperative blood loss.
比较不同三维（3D）半椎体形态的患者行单纯后路半椎体切除融合术后的临床和影像学结果。
回顾 2010 年 1 月至 2018 年 1 月期间因单半椎体导致先天性脊柱侧凸（CS）而行单纯后路半椎体切除融合术的患者资料。在评估 3D 计算机断层扫描图像后，CS 患者被分为一致半椎体组和不一致半椎体组。比较临床结果、影像学结果和并发症发生率。
本研究共纳入 42 例因单半椎体导致 CS 而行单纯后路半椎体切除融合术的患者。两组患者的节段性曲线 Cobb 角在术后和末次随访时均显著改善（均 P < 0.05）。术后和末次随访时，两组患者的并发症发生率、节段性曲线 Cobb 角、节段性曲线矫正率及其他影像学结果均无显著差异（均 P > 0.05）。与一致半椎体组相比，不一致半椎体组的手术时间（P = 0.006）和术中出血量（P = 0.037）增加。
对于具有一致半椎体或不一致半椎体的 CS 患者，单纯后路半椎体切除融合术可获得满意的影像学结果。在手术方面，不一致半椎体患者的影像学结果与一致半椎体患者相似，但不一致半椎体容易导致手术时间延长和术中出血量增加。
