Early clinical observation of posterior approach operation for rigid scoliosis caused by lumbosacral hemivertebra in adolescencts / 重庆医学

ABSTRACT

Objective To evaluate the early clinical outcome of one‐stage posterior approach operation for rigid scoliosis caused by lumbosacral hemivertebra in adolescencts .Methods Eighteen adolescencts with rigid scoliosis caused by lumbosacral hemivertebra were surgically treated by the posterior hemivertebral resection and long segment fixation .Hemivertebrae were sited in L5 (14 cases) ,S1 (4 cases) .There were 12 cases of full‐segmented hemivertebrae and 5 cases of semi‐segmented hemivertebrae and 1 case of wedge vertebral body ,10 patients had coronal trunk imbalance .Results The patients were successfully completed sur‐gery .The operation time was 4 .5-8 .5 h ,averaged 6 .3 h ;and the perioperative bleeding was 600-2 800 mL ,averaged 1 180 mL . 2 patient suffered from nerve root injury who received neuro nutrition drugs and Prednisolone after operation and recovered com ‐pletely after one weeks .All cases were follow ed up for 12-38 months ,averaged 21 .6 months .The coronal Cobb angles of lumbo‐sacral curve and proximal lumbar after one week of operations and at the time of the last follow‐up were much better than those be‐fore the operations ,the differences were statistically significant (P<0 .05) .Postoperative radiography demonstrated that no implant failure was observed .Coronal trunk shift was improved in 17 patients after surgery ,1 patient had coronal trunk decompensation . Conclusion The posterior surgery with hemivertebrae resection and long segment fixation is an effective procedure in the treatment of rigid scoliosis caused by lumbosacral hemivertebra in adolescencts .The reconstruction of the coronal plane is the key to the oper‐ation .