The Treatment of Hemivertebra Resection via the Posterior Approach along with Segments Internal Fixation for Congenital Kyphoscoliosis / 昆明医科大学学报

ABSTRACT

Objective To study the surgical strategies and techniques for the correction of congenital kyphoscoliosis with hemivertebra and evaluate the surgical results. Methods From June 2010 to June 2011,there were 6 congenital kyphoscoliostic patients with fully segmented hemivertebra were undergone hemivertebra resection through posterior approach, which included 4 males and 2 females with an average age of 15.7 years. The average Cobb angle of scoliosis was 73.4° (range, 52°~87°), the average Cobb angle of segmental kyphosis was 67.4° (range, 43°~89°) . The highest level of hemivertebrae was T9 and the lowest was L2. The surgical strategies were designed as followedFor the 2 cases without structural compensative curve, the posterior hemiverte-brae resection and short segmental internal fixation were performed. For the 4 cases with structural compensative curve, whose Risser signs were classified into 2-5, the hemivertebrae resection and long segmental internal fixa-tion were performed, and the compensative curve was included in the instrumentation level. Results The opera-tion time was 2.5~4.0 h (average,3.5 hours), the blood loss was 700-2 000 mL (mean,1 367 mL) . Numb-ness happened in one lower extremity postoperatively in 1 patient, and the symptom released in 1 month. The aver-age postoperative Cobb angle in coronal plane was 21.4° (11°~28°) with a correction rate of 67.9%. The aver-age postoperative Cobb angle in sagittal plane was 17.8° (12°~35°) with a correction rate of 75.2%. The fol-low-up period was from 26 months to 36 months (average, 26 months),no pseudoarthrosis,and obvious correc-tion loss either in coronal or sagittal plane was noted. Conclusion Hemivertebra resection and individualized oper-ation way has a good capability of correcting congenital kyphoscoliosis caused by hemivertebra.