Related Experiment Video
Updated: Mar 10, 2026
Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Hemivertebra Resection With Instrumented Fusion by Posterior Approach in Children
Lucas Piantoni1, Ida A Francheri Wilson1, Carlos A Tello1
1Servicio de Patología Espinal, Hospital Nacional de Pediatría, Prof. Dr. Juan P. Garrahan C.A.B.A., Buenos Aires, Argentina.
Insights
Posterior-only hemivertebra resection with instrumentation effectively corrects congenital scoliosis in children. This less invasive technique offers a secure and reliable solution for spinal deformities with good long-term outcomes.
Area of Science:
- Pediatric Orthopedics
- Spinal Surgery
- Congenital Deformities
Background:
- Congenital scoliosis often results from hemivertebra (HV) malformations.
- Previous treatments like hemiepiphysiodesis and in situ fusion had variable results.
- Anterior and posterior approaches for HV resection with instrumentation were previously advocated.
Purpose of the Study:
- To evaluate the outcomes of hemivertebra resection using a posterior approach only with spinal instrumentation.
- To assess the efficacy and safety of this technique for congenital scoliosis between 2002 and 2011.
Main Methods:
- Retrospective study of 67 patients (78 hemivertebrae) undergoing 70 surgical procedures.
- Mean patient age 5.5 years, mean follow-up 6.55 years.
- Inclusion of patients with various HV types and associated pathologies.
Main Results:
- Significant correction of scoliosis (38.55° to 19.89°) and kyphosis (29.98° to 15.41°).
- Low complication rate, including two superficial infections and two cases requiring revision for secondary curves.
- Successful fusion achieved in 64 patients.
Conclusions:
- Posterior-only hemivertebra resection with instrumentation is a safe, reliable, and less invasive surgical option.
- This technique effectively corrects congenital scoliosis in pediatric patients.
- The approach is well-tolerated and provides successful resolution of spinal deformities.
Study Design:
We conducted a retrospective study of patients with congenital scoliosis due to hemivertebra (HV) and performed resection with instrumentation through posterior approach-only with long term follow-up.
Objectives:
The objective of this study was to assess results of HV resection by posterior approach-only with instrumentation between 2002 and 2011.
Summary And Background Data:
Hemiepiphysiodesis, arthrodesis in situ and resection without instrumentation had been performed in the past with different results. Hemivertebra resection with spinal instrumentation through anterior and posterior approach has been advocated as the treatment of choice.
Methods:
A total of 67 patients with 78 HV and 70 surgical procedures were evaluated. Thirty-five of the patients were females and 32 were males. The mean age of the patients was 5.5 years (from 0.8 to 16 yr), and the mean follow-up period was 6.55 years (from 2.1 to 10.8 yr). Eighteen patients presented additional pathologies: specific syndromes, cardiopathies, thoracic, abdominal, and bone malformations. Sixteen patients had partial HV while 51 had full mobility HV. Twenty-eight of the HV were thoracic, 16 thoracolumbar, 28 lumbar, and six lumbosacral.
Results:
The scoliosis mean preoperative angular value was 38.55°, and the mean postoperative angular value was 19.89°. The kyphosis mean preoperative angular value was 29.98° and the mean postoperative angular value was 15.41°. One rod was used in 38 surgical procedures (54.28%) and 2 rods in 32 procedures (45.72%). We used monoaxial screws in 45 patients, poliaxial screws in 17 patients, and both monoaxial screws and poliaxial screws in one patient. Screws and hooks were used in one patient and hooks in three patients. Arthrodesis was performed in 64 patients, and no complications were registered in those without arthrodesis. Postoperative orthesis was used in 57 opportunities. Several complications during or after HV resection by posterior approach-only were reported. Two patients suffered from intraoperative neurophysiological complications, which were resolved during surgery with minimum gestures and presented no sequelae. Two patients developed superficial infections and needed toilette and IV antibiotic therapy. Two patients needed an additional surgery due to secondary curves, 4.9 yr after primary surgery on average. One patient developed crankshaft.
Conclusions:
We concluded that HV resection by posterior approach-only with instrumentation is a simple, secure, reliable, less invasive and well tolerated technique that can successfully resolve this kind of congenital scoliosis in children.
