Qian Chuang, Zhang Zhiqiang, Fu Dong, Wang Junfeng, Li Haodong, Zheng Yiming, Wang Dahui
Department of Orthopedics, Children's Hospital of Fudan University, National Children's Medical Center, Wan Yuan Road, Shanghai, 201102, China.
BMC Surg. 2025 Aug 11;25(1):364. doi: 10.1186/s12893-025-03114-1.
Hemivertebra (HV) is a leading cause of congenital scoliosis; however, the optimal timing for surgical intervention remains uncertain. This study aimed to compare surgical outcomes in children under 10 years old with scoliosis caused by a solitary simple lower thoracic or lumbar HV (T8-L5). From January 2015 to January 2024, we retrospectively analyzed 49 consecutive congenital scoliosis patients treated with posterior hemivertebra resection, fusion, and pedicle screw fixation. Of these, 35 patients met all inclusion criteria and were included in the final analysis. A minimum follow-up period of 12 months was maintained. We used ROC curve analysis to determine the age at which the rate of unplanned reoperation decreased, identifying a cutoff age of 5.07 years. Based on this criterion, we divided the pediatric population into two groups: the younger age group (≤ 5 years) and the older age group (> 5 years). No statistically significant differences were observed between the two groups in terms of correction rates in the coronal and sagittal planes. However, the unplanned reoperation rate was significantly higher in the younger age group (P = 0.016). Our findings suggest that delaying surgery until between five and ten years of age, combined with close follow-up, results in satisfactory outcomes with a lower rate of unplanned reoperation.
半椎体（HV）是先天性脊柱侧凸的主要病因；然而，手术干预的最佳时机仍不确定。本研究旨在比较10岁以下因孤立性单纯下胸段或腰段半椎体（T8-L5）导致脊柱侧凸的儿童的手术效果。2015年1月至2024年1月，我们回顾性分析了49例接受后路半椎体切除、融合和椎弓根螺钉固定治疗的先天性脊柱侧凸患者。其中，35例患者符合所有纳入标准并被纳入最终分析。维持至少12个月的随访期。我们使用ROC曲线分析来确定计划外再次手术率下降的年龄，确定截止年龄为5.07岁。基于该标准，我们将儿童人群分为两组：较年轻年龄组（≤5岁）和较年长年龄组（>5岁）。两组在冠状面和矢状面的矫正率方面未观察到统计学显著差异。然而，较年轻年龄组的计划外再次手术率显著更高（P = 0.016）。我们的研究结果表明，将手术推迟到5至10岁之间，并进行密切随访，可获得满意的结果，且计划外再次手术率较低。
