RESUMO
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 followed:For 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.
