Résumé
[Objective]To evaluate the clinical results of posterior hemivertebra resection and correction with transpedicular instrumentation for congenital scoliosis.[Method]From July 2002 to December 2006,thirty-nine consecutive cases,including 22 males and 17 females,underwent posterior hemivertebra resection and correction using transpedicular instrumentation.The average age at surgery was 8.3 years ranging from 3 to 15 years.There were 30 cases with fully segmented hemivertebra and 9 cases with partial segmented hemivertebra.Instrument included 16 cases of ISOLA,10 cases of CD-Horizon,10 cases of Moss-Miami and 3 cases of TSRH.The pre-and post-operative standing radiographic and at final follow-up were measured,and the Cobb's angles in the coronal and sagittal plane were analyzed,respectively.[Result]The average follow-up was 2.8 years ranging from 1 to 4.5 years.The Cobb's angle in coronal plane was corrected from 48? to 13?postoperatively and 13.2? at final follow-up,representing 70.2% correction rate.The kyphosis was corrected from 39? to 12.1? postoperatively and 12.7? at final follow-up,representing 68.7% correction rate.All cases had bony fusion,there was no neurological complication,no implant failure or infection.One case had crankshaft phenomenon.[Conclusion]Posterior hemiveterbra resection with instrumentation is a safe and effective treatment option for congenital scoliosis.Congenital scoliosis should be treated in early age.
Résumé
[Objective]To retrospectively analyze the complications of 528 cases of scoliosis surgery,and evaluate its strategy.[Method]From January 1980 to January 2001,528 patients with scoliosis underwent correction.There were 336 females and 192 males.The average age at surgery was 14.2 years.The average preoperation Cobb's angle was 48.2?(ranged from 34? to 102?).[Result]The patients were followed up for 3~24 years,the average was 12.5 years.The postoperative Cobb's angle averaged 24?.The average correction was 50.2%.Complications included 1 case of spinal cord injury,151 cases of sympathetic nerve injury,12 cases of superior mesenteric artery syndrom,6 cases of screw fracture,13 cases of rod fracture,3 cases of steel cable breakage,25 cases of hook displacement,20 cases of wire breakage,30 cases of flatback syndrome,6 cases of crankshaft phenomenon and 9 pseudoarthroses.[Conclusion]Satisfactory results could be obtained to treat scoliosis.